OBJECTIVE: To evaluate prevalence, age, position, predisposing factors, bacteriology, clinical features and outcomes of children with subdural empyema (SDE) and brain abscess (BA). DESIGN: Retrospective hospital-based study in a tertiary children's hospital. METHODS: Clinical data were reviewed on all children classified as having SDE or BA for 10.75 years from 1 January 1992 to 31 August 2003 at the Royal Alexandra Hospital for Children, Sydney, Australia. RESULTS: Forty-six children with intracranial suppuration were identified: 26 had BA, 16 had SDE and four children had both SDE and BA. Significant differences between SDE and BA were that: sinusitis was a predisposing factor for SDE (P = 0.01), Streptococcus milleri was the main organism isolated in SDE (P = 0.02), periorbital oedema (P = 0.005) and photophobia (P = 0.02) were clinical features specifically associated with SDE, and 75% of multiple abscesses were in females (P = 0.005). The age distribution of SDE was biphasic, with peaks at <2 years and >7 years. Cases of BA peaked at age 9-11 years. Forty-eight per cent of all children were between 9 and 13 years old; 20% were <1 year old. All the children with SDE and BA were aged 1 year or less. Three of the 46 children died, all with BA. Eighteen (39.1%) returned to normal and 25 (54.3%) had neurological complications. Neurological complications were more common in the BA group. CONCLUSION: The mortality rate of intracranial suppuration is low, but morbidity remains high. A high degree of suspicion is needed to diagnose and treat intracranial infections early.
OBJECTIVE: To evaluate prevalence, age, position, predisposing factors, bacteriology, clinical features and outcomes of children with subdural empyema (SDE) and brain abscess (BA). DESIGN: Retrospective hospital-based study in a tertiary children's hospital. METHODS: Clinical data were reviewed on all children classified as having SDE or BA for 10.75 years from 1 January 1992 to 31 August 2003 at the Royal Alexandra Hospital for Children, Sydney, Australia. RESULTS: Forty-six children with intracranial suppuration were identified: 26 had BA, 16 had SDE and four children had both SDE and BA. Significant differences between SDE and BA were that: sinusitis was a predisposing factor for SDE (P = 0.01), Streptococcus milleri was the main organism isolated in SDE (P = 0.02), periorbital oedema (P = 0.005) and photophobia (P = 0.02) were clinical features specifically associated with SDE, and 75% of multiple abscesses were in females (P = 0.005). The age distribution of SDE was biphasic, with peaks at <2 years and >7 years. Cases of BA peaked at age 9-11 years. Forty-eight per cent of all children were between 9 and 13 years old; 20% were <1 year old. All the children with SDE and BA were aged 1 year or less. Three of the 46 children died, all with BA. Eighteen (39.1%) returned to normal and 25 (54.3%) had neurological complications. Neurological complications were more common in the BA group. CONCLUSION: The mortality rate of intracranial suppuration is low, but morbidity remains high. A high degree of suspicion is needed to diagnose and treat intracranial infections early.
Authors: Saiful Azli Mat Nayan; Mohd Shafie Abdullah; Nyi Nyi Naing; Mohd Saffari Mohd Haspani; Ahmad Razali Md Ralib Journal: Malays J Med Sci Date: 2008-10
Authors: I Raffaldi; S Garazzino; G Castelli Gattinara; R Lipreri; L Lancella; S Esposito; A M Giannini; C Montagnani; G L Marseglia; C Pignata; F Bernardi; P-A Tovo Journal: Epidemiol Infect Date: 2017-08-03 Impact factor: 4.434
Authors: Fabian J S van der Velden; Alexandra Battersby; Lucia Pareja-Cebrian; Nicholas Ross; Stephen L Ball; Marieke Emonts Journal: BMC Pediatr Date: 2019-04-25 Impact factor: 2.125