[Clinical and bacteriological features of six cases with intracranial abscess in childhood].

From October 1988 to March 2001, 5 patients with 6 episodes of intracranial abscesses were admitted to Chiba-Children's Hospital. Average age when they were admitted was 10 years and 1 month. Initial clinical symptoms were fever in 5 cases, and headache in 1 case. It took 21 days from the appearance of the initial symptoms to diagnose the intracranial abscess. Four out of 5 patients had underlying diseases that were prone to cause intracranial abscess. Two patients of these were cyanotic congenital heart diseases (tetralogy of Fallot and asplenic heart), and the other 2 were sinusitis. Computed tomography revealed that brain abscess was found in 5 cases, and subdural empyema in 1 case. There were 3 single and multiple abscesses each. The most common lesion was the temporal lobe. Eight bacterial strains were isolated from 5 cases. Five were streptococci (3 were Streptococcus milleri group, other 2 were Streptococcus oralis and microaerophilic Streptococcus) and 3 were anaerobes (Prevotella loescheii, Prevotella bivia and Fusobacterium nucleatum). Antimicrobial therapy was started with panipenem-betamiprone in 3 cases, imipenem-cilastatin, ceftriaxone, and ampicillin in the other cases resre ctinely. Duration of therapy ranged from 28 to 67 days (45 days, average). In 5 cases, drainage with craniotomy was performed in addition to antimicrobial therapy. One case was treated medically alone, but this was the only case with recurrence after 1 year 2 months. There were no serious complications such as intraventricular rupture of abscess. All patients had good outcomes, but mild neurological sequela was found in 1 case.