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小儿脑脓肿:单中心经验

Paediatric brain abscesses: a single centre experience.

作者信息

Hall Samuel, Yadu Shirley, Gaastra Benjamin, Mathad Nijaguna, Sparrow Owen, Waters Ryan, Chakraborty Aabir, Tsitouras Vassilios

机构信息

Department of Neurosurgery, University Hospitals Southampton NHS Foundation Trust , Southampton , UK.

Faculty of Medicine, University of Southampton , Southampton , UK.

出版信息

Br J Neurosurg. 2019 Oct;33(5):550-554. doi: 10.1080/02688697.2019.1587381. Epub 2019 May 26.

Abstract

Brain parenchymal abscesses are relatively infrequent but potentially serious infections in the paediatric population. Surgical intervention in addition to a prolonged administration of antibiotics is generally appropriate management. This study presents our centre's experience of managing such patients in the context of relevant literature. A single-centre retrospective case note review was conducted over a 15 year period (2003-2017). Patients were selected from electronic hospital records using ICD10 code G06.0. Patients < 18 years of age with a confirmed intra-parenchymal abscess were included. Patient records were reviewed for abscess location, microbiology results, surgical intervention, and outcome using the Glasgow Outcome Score at 3 months. Twenty-four patients were identified (mean age: 7.4 ± 5.3 years, male  = 11). Twelve (50.0%) patients had an abscess in the frontal lobe and was the most common causative microorganism ( = 15). Nineteen patients (79.2%) had an identifiable source which included: ENT infections, congenital cardiac malformations, recent dental surgery and meningitis. All 24 patients underwent surgery with 20 patients having a total of 32 aspirations between them and the other 4 having craniotomy and excision. Twenty patients had 3 month follow-up data of which 18 patients scored GOS: 5, one was GOS: 4 and one was GOS: 3. Brain parenchymal abscess remains an uncommon pathology in the paediatric population. The majority of patients have a preceding infection with as the most common causative organism. Antimicrobial therapy should be selected accordingly. All of our patients underwent surgical intervention and received intravenous antibiotics with favourable outcome and no mortality.

摘要

脑实质脓肿在儿科人群中相对少见,但可能是严重感染。除了长期使用抗生素外,手术干预通常是合适的治疗方法。本研究结合相关文献介绍了我们中心治疗此类患者的经验。我们进行了一项为期15年(2003 - 2017年)的单中心回顾性病例记录审查。使用ICD10编码G06.0从电子医院记录中选取患者。纳入年龄小于18岁且确诊为脑实质内脓肿的患者。使用格拉斯哥预后评分在3个月时对患者记录进行脓肿位置、微生物学结果、手术干预和预后的审查。共确定了24例患者(平均年龄:7.4±5.3岁,男性11例)。12例(50.0%)患者额叶有脓肿, 是最常见的致病微生物( = 15)。19例患者(79.2%)有可识别的感染源,包括:耳鼻喉感染、先天性心脏畸形、近期牙科手术和脑膜炎。所有24例患者均接受了手术,其中20例患者共进行了32次穿刺抽吸,另外4例进行了开颅切除手术。20例患者有3个月的随访数据,其中18例患者格拉斯哥预后评分为5分,1例为4分,1例为3分。脑实质脓肿在儿科人群中仍然是一种罕见的病理情况。大多数患者有先前感染, 是最常见的致病微生物。应相应选择抗菌治疗。我们所有患者均接受了手术干预并接受了静脉抗生素治疗,预后良好,无死亡病例。 (注:原文中部分表述有缺失或不完整,翻译时尽量按照现有内容准确翻译)

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