Multiple brain abscesses with good prognosis in an infant with cyanotic congenital heart disease: a case report

Journal of Medical Case Reports
Atsuko Kudo-KuboAkira Ashida

Abstract

Brain abscesses are relatively rare, but they are a potentially life-threatening condition. Predictive factors for poor outcome are a young age and the presence of multiple abscesses. We report a case of a 15-month-old girl with cyanotic congenital heart disease who developed multiple brain abscesses caused by Streptococcus intermedius. The patient was treated with a combination of surgical aspiration and antimicrobial therapy without apparent neurological sequelae. To the best of our knowledge, this is the youngest such patient to have been reported in the literature. We explore the possible causes of her good outcome. At the age of 15 months, the Japanese patient initially was presented to our hospital with transient eye deviation to the left and vomiting. In a blood examination, her white blood cell count (12,720 per mm3 with a left shift) and C-reactive protein level (1.23 mg/ml) were slightly elevated. Magnetic resonance imaging of the brain showed three mass lesions. These were 1.5-cm, 1.9-cm, and 1.2-cm rim-enhancing lesions with extensive surrounding edema. Brain abscesses were diagnosed, and vancomycin (50 mg every 12 hours) and meropenem (40 mg every 8 hours) were started empirically. However, because each brain absce...Continue Reading

References

Jan 1, 1972·Journal of Neurosurgery·M E CareyL A French
Aug 26, 1999·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·A V CiureaL Nuteanu
Jun 3, 2004·Pediatrics·Howard P GoodkinScott L Pomeroy
Jun 4, 2008·Neurosurgical Focus·James L FrazierGeorge I Jallo
Sep 25, 2012·The Pediatric Infectious Disease Journal·Susanna FelsensteinPenelope A Bryant
Jul 31, 2014·The New England Journal of Medicine·Matthijs C BrouwerDiederik van de Beek

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Methods Mentioned

BETA
surgical aspiration

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