Pediatric brain abscess clinical profile, management and outcome at tertiary care centre in Nepal

• Main Authors: Prakash Kafle, Mohan Raj Sharma, Sushil Krishna Shilpakar, Gopal Sedain, Amit Pradhanang, Ram Kumar Shrestha, Binod Raj Bhandari, Babita Khanal
• Format: Article
• Language: English
• Published: College of Medical Sciences 2018-07-01
• Series: Journal of College of Medical Sciences-Nepal
• Online Access: https://www.nepjol.info/index.php/JCMSN/article/view/20339
• ISSN: 2091-0657; 2091-0673

<p><strong>ABSTRACT</strong></p><p><strong><span class="fontstyle0">Background: </span></strong><span class="fontstyle2">Brain abscess in pediatric population is serious life threatening problem. Many risk factors are associated with this entity like congenital heart disease, ear infection and immunocompromised state. Early diagnosis and treatment with minimal invasive procedure has good outcome. </span></p><p><strong><span class="fontstyle0">Materials and Methods</span></strong><span class="fontstyle2"><strong>:</strong> This is a hospital based cross-sectional study conducted at institute of Medicine (IOM), Tribhuvan University Teaching Hospital Kathmandu, Nepal over the period of 3 years between September 2014 to August 2017. Clinical profile, management and outcome were analyzed. </span></p><p><strong><span class="fontstyle0">Results</span></strong><span class="fontstyle2"><strong>:</strong> A total of 27 cases were taken for the surgical management in the present study. There were 18 male and 9 female with the male to female ratio of 2:1. Mean age of the study population was 7.08 years. Otogenic Abscess was the most common 37.03% (n=10) and the temporal lobe was the most common site (37.5%). Headache was the most common clinical presentation seen in 74.07 %. All the cases were initially managed with the burrhole and aspiration. Only 14.8 %( n=4) of cases subsequently required surgical excision of the abscess wall. Only18.5 %( n=5) of the cases required multiple session aspiration. Positive culture was seen in 25.9% (n=7). Pseudomonas aeruginosa and E.coli were the commonest organisms grown. Mortality rate was 3.7%.<br /></span></p><p><strong><span class="fontstyle0">Conclusion</span></strong><span class="fontstyle2"><strong>:</strong> Modern advances in radio imaging and multidisciplinary team involvement has decreased the morbidity and mortality.</span></p><p><strong><span class="fontstyle0">Keywords: </span></strong><span class="fontstyle2">otogenic brain abscess; pediatric brain abscess; tubercular abscess.</span> <br /><br /></p>