Skip to main content
Log in

Brain abscess in children

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objectives: Brain abscess is a serious life-threatening complication of several diseases. The objective of this study was to look at the clinical profile of patients, predisposing conditions, microbiology and outcome of children suffering from brain abscess.Methods: Thirty children aged less than 15 years were reviewed. There were 15 males and 15 females. The mean age of presentation was 5.6±4.4 years.Results: The duration of illness at the time of admission was 17.6±24.6 days. Typically patients presented with fever, vomiting, headache and seizures. The predisposing conditions found were cyanotic congenital heart disease in 11 (37%) of children, meningitis in 6 (20%), septicemia in 7 (23%), and no underlying cause was found in 5 (17%) children. The most common microbe in children with cyanotic congenital heart disease was of theStreptococcus milleri group (52%). Computerized tomography confirmed the diagnosis and the most common location of the abscess was the parietal lobe of the cerebral hemisphere. All abscesses were large, more than 2 cm in diameter and were aspirated surgically. Excision was performed in 6 children. Five children expired, one due to a intracranial bleeding and the others due to severe cerebral edema and tentorial herniation. Complications were seen in 20 children and 16 had sequelae, hemiparesis in 11 and seizure disorder in 5.Conclusion: Brain abscess is a serious infection with poor outcome if diagnosed late. Delayed surgical drainage has high morbidity and mortality. The threshold for diagnosis should be low, particularly in children with a predisposing condition like cyanotic congenital heart disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Brook I. Brain abscess in children; microbiology and management.J Child Neurol 1995; 10(4): 283–288.

    PubMed  CAS  Google Scholar 

  2. Goodkin HP, Harper MB, Pomeroy SL. Intracranial abscess in children: Historical trends at Children’s hospital, Boston.Pediatrics 2004; 111(8): 1765–1770.

    Article  Google Scholar 

  3. Piper C, Horstkotte B, Arendt G, Strauer BE. Brain abscess in children with cyanotic heart defects.Z Kardiol 1994; 83(3): 188–193.

    PubMed  CAS  Google Scholar 

  4. Parikh S, Bharucha B, Kamdar S, Kshirsagar N. Polymorphonuclear leucocyte functions in children with cyanotic and acyanotic heart disease.Indian Pediatr 1993; 10(7): 883–890.

    Google Scholar 

  5. Malik S, Joshi SM, Kandoth PW, Vengsarkar US. Experience with brain abscesses.Indian Pediatr 1994; 31(6): 661–666.

    PubMed  CAS  Google Scholar 

  6. Takeshita M, Kagawa M, Yonetani H, Izawa M, Yato S, Nakanishi T, Monma K. Risk factors for brain abscess in patients with congenital cyanotic heart disease.Neurol Med Chir 1992; 32(9): 667–670.

    Article  CAS  Google Scholar 

  7. Aebi C, Kauffmann F, Schaad UB. Brain abscess in childhood-long term experience.Eur J Pediatr 1991; 150(4): 282–286.

    Article  PubMed  CAS  Google Scholar 

  8. Pit S, Jamal F, Cheak FK. Microbiology of cerebral abscess: a four year study in Malaysia.J Trop Med Hyg 1993; 96(3): 191–196.

    PubMed  CAS  Google Scholar 

  9. Pandian JD, Monma NV, Cherian PJ, Radhakrishnan K. Brainstem abscess complication tetralogy of Fallot successfully treated with antibiotics alone.Neurol India 200; 48(3): 272–275.

  10. Yang SY. Brain abscess associated with congenital heart disease.Surg Neurol 1989; 31(3): 129–132.

    PubMed  CAS  Google Scholar 

  11. Puthucheary SD, Parasakthi N. The bacteriology of brain abscess: a local experience in Malyasia.Trans R Soc Trop Med Hyg 1990; 84(4): 689–692.

    Article  Google Scholar 

  12. Sineviratne RS, Navasivayam P, Perera S, Wickremasinghe RS. Microbiology of brain abscess at a neurosurgical unit of the National Hospital of Sri Lanka.Ceylon Med J 2003; 48(1): 14–16.

    Google Scholar 

  13. Weghtman NC, Barnham MRD, Dove M. Streptococcus milleri group bacteremia in North Yorkshire, England (1989–2000).Indian J Med Res 2004; 119 (Suppl): 164–167.

    Google Scholar 

  14. Woo PC,et al. “Streptococcus milleri” endocarditis caused by streptococcus anginosus.Diagn Microbiol Infect Dis 2004; 48 (2): 81–88.

    Article  PubMed  Google Scholar 

  15. Kanamori S, Kusano N, Shinzato T, Saito A. The role of capsule of streptococcus milleri group in its pathogenicity.J Infect Chemother 2004; 10(2): 105–109.

    Article  PubMed  Google Scholar 

  16. Yanagihara C, Wada Y, Nishimura Y. Infectious endocarditis associated with subarachnoid hemorrhage, subdural hematoma and multiple brain abscesses.Intern Med 2003; 42(12): 1244–1247.

    PubMed  Google Scholar 

  17. Guerin Pet al. Cerebral abscess and cyanotic congenital heart disease.Arch Mal Coeur Vaiss 1997; 90(5): 651–654.

    PubMed  CAS  Google Scholar 

  18. Gosh S, Chandy MJ, Abraham J. Brain abscess and congenital heart disease.J Indian Med Assoc 1990; 88(11): 312–314.

    Google Scholar 

  19. Takeshita M, Kagawa M, Yato S, Izawa M, Onda H, Takakura K, Mom K. Current treatment of brain abscess in patients with congenital cyanotic heart disease.Neurosurgery 1997; 41(6): 1270–1279.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mehnaz Atiq.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atiq, M., Ahmed, U.S., Allana, S.S. et al. Brain abscess in children. Indian J Pediatr 73, 401–404 (2006). https://doi.org/10.1007/BF02758560

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02758560

Key words

Navigation