Three cases of brain abscesses in neonates

Cerebral abscess is a rare complication of infectious diseases, but is associated with high morality or severe neurological and developmental consequences. The diagnosis of cerebral abscess is difficult, because the primary symptoms are nonspecific and in many cases neurological signs do not appear.

We report 3 cases admitted to the second Neonatology Clinic of The Medical University of Warsaw. All infants were under 1 month of age. There were two girls and one boy. On admission they presented with such symptoms as fever, irritability, vomiting, grunting, poor feeding, and other nonspecific symptoms of infection. Blood examinations showed increased values of WBC and accelerated ESR. CSF examinations revealed pleocytosis and increased protein values. All patients were diagnosed by ultrasound . The site of the abscess in all babies was the occipital region of the brain . There was hydrocephalus in each case. In two children the pathogenic factor was Listeria Monocytogenes, and in one was unknown. The treatment included aspiration of the abscess cavity and intravenous and intracranial administration of antibiotics. The duration of treatment was from 6 to 7 weeks. Ventriculo-peritoneal shunts were implanted for treatment of hydrocephalus. All infants were given anticonvulsants. Steroids were used twice.

It is important to emphasize that early diagnosis is the key to successful treatment.