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OP-019 A fatal case of multiple brain abscesses – case presentation
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  1. Abel Deak,
  2. Mate David,
  3. Beata Rosdy,
  4. Ferenc Fekete,
  5. Beata Visy,
  6. Viktoria Kiss,
  7. Eva Kovacs
  1. Heim Pal National Institute of Pediatrics

Abstract

Aim Brain abscess and empyema are life-threatening intracranial infectious diseases with high rates of disability and mortality. Recent advances in diagnosis, antimicrobial therapy, and neurosurgical treatment have contributed to a gradual decrease in the incidence and mortality of these diseases. Between the years 2021 and 2022, we observed a significant increase in the pediatric population in our center (6 and 7 cases, respectively). The annual incidence in the previous years was 0–2 cases per year. The most common pathogens were viridans streptococci, especially Streptococcus intermedius. Ear-nose-throat infections dominated as the source of abscesses. In this case report, we present a fatal case of multiple brain abscesses from this period. The 9-year-old boy living with Down-syndrome presented at our Emergency Department with fever and opisthotonos. Imaging studies revealed eight parenchymal brain abscesses with drainage to the ventricles. Neurosurgical intervention was not indicated due to the size and number of abscesses, therefore lumbar puncture was performed and isolated Streptococcus intermedius. Despite the adequate antimicrobial and intensive care treatment, the child passed away eventually. The etiology of brain abscesses was not identified. During this period, this patient was the only case of intracranial abscesses via hematogenous route and fatal outcome.

  • brain abscess
  • Streptococcus intermedius
  • hematogenous spread

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