Brain Abscess Clinical Presentation, Microbiology, Management, and Outcome: Evidence from a Tertiary Pediatric Center

Objectives: Brain abscess (BA) is a life-threatening infection affecting the brain parenchyma. It can be caused by various microorganisms and often occurs due to underlying etiology. This study aimed to assess the clinical profile, etiology, paraclinical data, and outcomes of pediatric BA. Materials and Methods: This retrospective descriptive study was conducted at the Children’s Medical Center Hospital in Tehran, Iran, from 2010 to 2020. Diagnosis was based on clinical presentation and imaging. Data was collected for each patient from the hospital database. Results: A total of 45 patients were included in the study. The mean age of patients was 4.93 years (range: 2 months old-18 years old (216 months old) (SD: 58.16 months)), with a male-to-female ratio of 1.36:1. The most frequent clinical symptoms were vomiting, headache, and fever. Streptococcus viridans was the most common organism isolated (25%), though causative organisms were identified in only 35.5% of cases. Predisposing factors included cyanotic heart disease (CHD) (17.7%), meningitis (6.6%), and otitis media (6.6%). The most involved anatomical regions were the frontal lobe (35.5%) and then the multiple lobes (26.6%), respectively. Antibiotic treatment resulted in the cure of 23 patients (51.1%), while 22 patients (48.9%) required surgical abscess drainage in addition to antibiotics. The average hospital stay was 39 days and overall mortality was 6.66%. Conclusion: Considering BA in patients with CHD, meningitis, and otitis media helps in earlier diagnosis. Early initiation of antibiotics and selection based on the causative organism can improve BA outcomes in children.