Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Brain abscess in Korean children: A 15-year single center study

  • Lee, Cha-Gon (Department of Pediatrics, School of Medicine, Sungkyunkwan University, Samsung Medical Center) ;
  • Kang, Seong-Hun (Department of Pediatrics, School of Medicine, Sungkyunkwan University, Samsung Medical Center) ;
  • Kim, Yae-Jean (Department of Pediatrics, School of Medicine, Sungkyunkwan University, Samsung Medical Center) ;
  • Shin, Hyung-Jin (Department of Neurosurgery, School of Medicine, Sungkyunkwan University, Samsung Medical Center) ;
  • Choi, Hyun-Shin (Department of Pediatrics, School of Medicine, Sungkyunkwan University, Samsung Medical Center) ;
  • Lee, Jee-Hun (Department of Pediatrics, School of Medicine, Sungkyunkwan University, Samsung Medical Center) ;
  • Lee, Mun-Hyang (Department of Pediatrics, School of Medicine, Sungkyunkwan University, Samsung Medical Center)
  • 투고 : 2009.09.15
  • 심사 : 2009.12.01
  • 발행 : 2010.05.15
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초록

Purpose: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were $S$ $intermedius$ (n=3), $S$ $aureus$ (n=3), $S$ $pneumoniae$ (n=1), Group B streptococcus (n=2), $E.$ $coli$ (n=1), $P.$ $aeruginosa$ (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

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참고문헌

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