Abstract

ABSTRACT
Background: Brain abscess in children is a neurosurgical emergency with potentially catastrophic outcome 
despite the advances made in neuroimaging techniques and antibiotic therapy. Symptoms are nonspecific and 
may vary with the child’s age, location, size, numbers and stage of abscess, and the primary source of infection. 
Treatment is usually with broad-spectrum antibiotics in combination and surgical evacuation in most cases or 
antibiotics alone in selected cases with clear-cut indications. This study was to document clinical characteristics, 
etiological factors, and spectrum of bacteriologic agents responsible for pediatric brain abscess in an African city, 
the challenges and management outcome over the study period.
Methods: This was a retrospective study over an 11-year period involving 89 children who presented with brain 
abscess. Information of interest was extracted from the medical records of each participant. The results from data 
analysis were presented in charts and tables.
Results: Eighty-nine children aged 0.85–15.7  years (median age of 6.4  years) met the inclusion criteria. The 
male-to-female ratio was 1.8:1. Headache (80%), fever (78%), and hemiparesis (78%) were the most common 
symptoms. Brain imaging deployed was CT scan in 56  (63%), MRI in 9  (10%), and transfontanel ultrasound 
scan in 24 (27%) children. Seventy-one (80%) children had antibiotics with surgical evacuation while 18 (20%) 
children received only antibiotics. In 19  (27%) children, the culture of the abscess was negative. In 53  (75%) 
children, Gram-positive aerobic organisms were isolated. A total of 75 patients (84%) had a favorable outcome.
Conclusion: Pediatric brain abscess still poses significant public health challenge, especially in resource-limited 
regions. Successful management of brain abscess requires high index of suspicion for early diagnosis, referral, and 
intervention