Kumar Sunil, Kumar Pradeep, Sanker Vivek, Aujla Savvy, Handu Kanika, Richard Riya Mary, Gayathri S, Dave Tirth
Department of Neurosurgery, Trivandrum Medical College Hospital, India.
Team Erevnites, India.
eNeurologicalSci. 2025 Jun 3;40:100572. doi: 10.1016/j.ensci.2025.100572. eCollection 2025 Sep.
Neonatal brain abscess is a focal intracerebral infection that, although rare in neonates, is associated with high mortality rates and long-term complications. In neonates, it mainly occurs as a complication of neonatal sepsis and meningitis. This case series reports three cases of neonatal brain abscesses involving infants who presented with fever and other symptoms and were treated with antibiotics, surgical evacuation, and prophylactic anti-epileptic treatment. Following treatment, all infants showed marked radiological improvement and reduced abscess size. In addition, pus culture, blood culture, and CSF analysis reports were typical. Despite the severe nature of the condition, all three infants recovered well and achieved appropriate developmental milestones.
Neonatal brain abscess should be suspected in neonates with sepsis or meningitis developing fever, poor feeding, seizures, or general deterioration of health despite treatment. It is most commonly caused by gram-negative bacteria. However, in many instances, like in our 3 cases, sterile fluid may be aspirated from a brain abscess, which is considered a good prognostic factor.
Early diagnosis of neonatal brain abscess with high clinical suspicion use of neuroradiological imaging and prompt treatment with sensitive antibiotics and neurosurgical interventions can improve the prognosis and reduce its complications.
新生儿脑脓肿是一种局灶性颅内感染，尽管在新生儿中罕见，但与高死亡率和长期并发症相关。在新生儿中，它主要作为新生儿败血症和脑膜炎的并发症出现。本病例系列报告了3例新生儿脑脓肿病例，这些婴儿表现出发热和其他症状，并接受了抗生素、手术引流和预防性抗癫痫治疗。治疗后，所有婴儿的影像学表现均有明显改善，脓肿大小减小。此外，脓液培养、血培养和脑脊液分析报告均典型。尽管病情严重，但所有3例婴儿恢复良好，达到了适当的发育里程碑。
对于患有败血症或脑膜炎且出现发热、喂养困难、惊厥或尽管接受治疗但健康状况普遍恶化的新生儿，应怀疑患有新生儿脑脓肿。它最常见由革兰氏阴性菌引起。然而，在许多情况下，如我们的3例病例，从脑脓肿中抽出的液体可能无菌，这被认为是一个良好的预后因素。
对新生儿脑脓肿进行早期诊断，高度临床怀疑时使用神经放射影像学检查，并及时使用敏感抗生素和神经外科干预进行治疗，可改善预后并减少其并发症。
