RT Journal Article
SR Electronic
T1 Brain abscess in children, a two-centre audit: outcomes and controversies
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 288
OP 291
DO 10.1136/archdischild-2018-316730
VO 105
IS 3
A1 Vianney Gilard
A1 Kévin Beccaria
A1 John C Hartley
A1 Stéphane Blanot
A1 Sophie Marqué
A1 Marie Bourgeois
A1 Stephanie Puget
A1 Dominic Thompson
A1 Michel Zerah
A1 Martin Tisdall
YR 2020
UL http://adc.bmj.com/content/105/3/288.abstract
AB Objective The aim of this study was to better characterise clinical presentation, management and outcome in infants and children with brain abscess.Methods The authors conducted a retrospective, multicentre study in two national reference centres over a 25-year period (1992–2017). During this period, 116 children and 28 infants (age <1 year) with brain abscess were treated.Results The median age at diagnosis was 101.5 (range: 13–213) months in children and 1 (0–11) month in infants. Significant differences were observed between children and infants. The most common predisposing factor was meningitis in infants (64% of cases vs 3% in children), while it was otolaryngology-related infection in children (31% of cases vs 3.6% in infants). Infants presented more frequently with fever and meningism compared with children. 115 patients were treated with aspiration and 11 with excision. Reoperation was required in 29 children vs 1 infant. The overall mortality rate was 4% (3.4% for children, 7.1% for infants). At 3-month follow-up, the outcome was favourable in 86% of children vs in 68% of infants.Conclusion There is a clear difference between children and infants with brain abscess in terms of predisposing factors, causative organisms and outcome. Despite surgical drainage and directed antibiotic therapy, 25% of patients with brain abscess require reoperation. Mortality is improved compared with historical series; however, long-term morbidity is significant particularly in the infant population.