OBJECTIVE: To find out the clinical presentation, radiological characteristics, various underlying predisposing conditions and causative organisms of brain abscess in children in our setup. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Children's Hospital and the Institute of Child Health, Lahore, over two years from September 2001 to August 2003. PATIENTS AND METHODS: All children (< 16 years) presenting with brain abscess were included to study demographic, clinical and radiological features. In addition, attempts were made to find out underlying predisposing conditions and causative organisms. RESULTS: Twenty-five children with brain abscess were managed over 2 years. The mean age was 7.8 years (range 9 months to 16 years). Male to female ratio was 2.1:1. Most patients (43%) presented with 4 weeks history of illness, with mean duration of illness at presentation of 29.3 days. Main presenting complaints were fever (72%), vomiting (48%), headache (44%) and convulsions (32%). Five patients (20%) had papilledema at presentation, another 4 (16%) had paresis/paralysis and 3 (12%) had cranial nerve palsies. Majority (64%) had solitary abscess, located in parietal, temporal, frontal and occipital lobes in order of frequency. No underlying predisposing condition was identified in 8 (32%) cases; while 8 (32%) had cyanotic congenital heart disease, 5 (20%) patients had otic infection (mastoiditis), 2 (8%) were postoperative cases and one each developed brain abscess secondary to ventriculo-peritoneal (VP) shunt infection and pulmonary tuberculosis. Causative organisms were isolated in 40% cases, which included staphylococcus aureus, Staphylococcus epidermidis, Streptococcal species, Klebsiella, E. coli and Proteus. CONCLUSION: Awareness of predisposing factors, early recognition of clinical features and understanding of the prevalent microbial profile is imperative for better management of children with brain abscess.
OBJECTIVE: To find out the clinical presentation, radiological characteristics, various underlying predisposing conditions and causative organisms of brain abscess in children in our setup. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Children's Hospital and the Institute of Child Health, Lahore, over two years from September 2001 to August 2003. PATIENTS AND METHODS: All children (< 16 years) presenting with brain abscess were included to study demographic, clinical and radiological features. In addition, attempts were made to find out underlying predisposing conditions and causative organisms. RESULTS: Twenty-five children with brain abscess were managed over 2 years. The mean age was 7.8 years (range 9 months to 16 years). Male to female ratio was 2.1:1. Most patients (43%) presented with 4 weeks history of illness, with mean duration of illness at presentation of 29.3 days. Main presenting complaints were fever (72%), vomiting (48%), headache (44%) and convulsions (32%). Five patients (20%) had papilledema at presentation, another 4 (16%) had paresis/paralysis and 3 (12%) had cranial nerve palsies. Majority (64%) had solitary abscess, located in parietal, temporal, frontal and occipital lobes in order of frequency. No underlying predisposing condition was identified in 8 (32%) cases; while 8 (32%) had cyanotic congenital heart disease, 5 (20%) patients had otic infection (mastoiditis), 2 (8%) were postoperative cases and one each developed brain abscess secondary to ventriculo-peritoneal (VP) shunt infection and pulmonary tuberculosis. Causative organisms were isolated in 40% cases, which included staphylococcus aureus, Staphylococcus epidermidis, Streptococcal species, Klebsiella, E. coli and Proteus. CONCLUSION: Awareness of predisposing factors, early recognition of clinical features and understanding of the prevalent microbial profile is imperative for better management of children with brain abscess.