The Clinical Features Of 29 Infants With Brain Abscess

Objective:The purpose of this study is to explore the clinical features of infant brain abscess and improve the understanding of brain abscess in infant.Methods:The 29 patients with brain abscess admitted to Children’s Hospital of Chongqing Medical University from May 2003 to December 2020 were retrospectively analyzed,including the clinical manifestations,laboratory examination,imaging examination,diagnosis,complications,treatment and prognosis.Results:1.The average gestational age was 38.3±2.9 weeks(30⁺⁶-40⁺³weeks),and the average birth weight was 3087.5±523.7g（1900-3900g）.2.The clinical manifestations of infant brain abscess are atypical,and some patients have normal blood routine and inflammatory indexes,which delay the diagnosis and treatment.Cerebrospinal fluid examination and head MRI examination is helpful for earlier identification of brain abscess.3.Infant brain abscess were mainly hematogenic multiple brain abscesses,most of which were located in frontal lobe,occipital lobe and temporal lobe.The pathogens were mainly Escherichia coli.4.The average time from the onset of symptoms to the starting of anti-infective treatment was 4 days（range 1-30 days）.The mean anti-infectiveduration of patients without surgery was 19.9 days（range 1-69 days）,The mean duration of patients treated by surgery was 43 days（range 13-130 days）.Surgical methods included abscess resection in 3 cases,OMMAYA sac implantation in 1 case,ventricular drainage in 1case,epidural drainage in 1 case.5.The patients with brain abscess and respiratory failure were mainly central respiratory failure,the ventilator parameters is low and the respiratory support duration is short.Controlled hyperventilation could relieve respiratory failure and intracranial hypertension.Conclusion:1.The clinical manifestations of brain abscess in infants are atypical,and inflammatory indicators in some patients are normal.CSF examination and head MRI examination is helpful for earlier diagnosis.2.Infant brain abscesses are mainly multiple abscesses caused by sepsis,The main treatment are anti-infection and symptomatic supportive treatment.Some children with severe hydrocephalus should remove the abscess or drainage the cerebrospinal fluid by surgery.Some patients were treated with linezolid by oral.3.If patients have brain abscess combined with respiratory failure,Controlled hyperventilation treatment can relieve respiratory failure and intracranial hypertension.