Microbiology and management of brain abscess in children

Brain abscess is an uncommon but serious life threatening infection in children. The infection can originate from contiguous sites of existing infections, such as chronic otitis media, dental infection, mastoiditis, or sinusitis. The infection can also occur in children with cyanotic congenital heart disease where the predominant organisms are viridans, microaerophilic, or anaerobic streptococci or following head trauma where Staphylococcus aureus, viridans Streptococci and Streptococcus pneumoniae are the most prevalent isolates. Brain scans, computerized tomography and magnetic resonance imaging are important tools that enable accurate diagnosis of the infection. Proper selection of antimicrobial with good intracranial penetration is critical in the management of intracranial infection. Brain abscess, especially in the early phase of cerebritis, may respond to antimicrobial therapy without the need for surgical drainage. Delay in surgical drainage can be associated with high mortality or morbidity. (J Pediatr Neurol 2004; 2(3): 125-130)