Pediatric Infectious Diseases Unit, Meyer Children's Hospital, Rambam Health Care Campus and the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Acta Paediatr. 2010 Aug;99(8):1163-7. doi: 10.1111/j.1651-2227.2010.01780.x. Epub 2010 Feb 23.
Brain abscess is rare in children. Predisposing factors are found in almost 85% of cases. Overall, 25% of brain abscesses develop in children, mostly in the 4-7 years age group. Our study aimed to characterize children with brain abscesses treated in our hospital, identify risk factors, pathogens and short-term outcome.
A retrospective cohort of 20 years period, (1989-2009) included 27 children (0-18 years). Medical records were analysed for age, gender, presenting symptoms and signs, predisposing factors, laboratory tests, imaging, microbiology results, treatment and outcome.
Of all the children, 63% (17/27) were male patients; mean age was 7.9 years and 52% were referred from other hospitals. Predisposing factors were identified in 81%, congenital heart disease and otitis were rare and sinusitis was found in 22% of the children. Main symptoms and signs included headaches, fever, neurological signs convulsions, (41%, 81%, 78% and 41% respectively). In 30% of cases, cultures were sterile. All patients were operated in addition to antibiotic treatment. Outcome was good with low mortality rate (3.7%).
Manifestations of brain abscess may be subtle. A high index of suspicion and early imaging are warranted, different predisposing factors may reflect early intervention for congenital heart diseases. Mortality is rare in the modern medicine era.
脑脓肿在儿童中较为罕见。近 85%的病例存在诱发因素。总体而言，25%的脑脓肿发生在儿童，主要在 4-7 岁年龄组。我们的研究旨在描述在我院治疗的脑脓肿患儿的特征，确定危险因素、病原体和短期预后。
对 20 年期间（1989-2009 年）的 27 例儿童（0-18 岁）进行回顾性队列研究。分析病历记录中的年龄、性别、首发症状和体征、诱发因素、实验室检查、影像学、微生物学结果、治疗和结局。
所有患儿中，63%（17/27）为男性患者；平均年龄为 7.9 岁，52%为外院转诊。81%的患儿存在诱发因素，先天性心脏病和中耳炎少见，22%的患儿有鼻窦炎。主要症状和体征包括头痛、发热、神经系统体征（分别为 41%、81%、78%和 41%）。30%的病例培养结果为无菌。所有患者均在接受抗生素治疗的同时进行手术治疗。结局良好，死亡率低（3.7%）。
脑脓肿的表现可能不明显。需要高度怀疑和早期影像学检查，不同的诱发因素可能反映了对先天性心脏病的早期干预。在现代医学时代，死亡率罕见。
