Experience with surgical evacuation of neonatal brain abscess: A patient series and review of literature.

BACKGROUND

Neonatal brain abscess is a focal intracerebral infection that, although rare in neonates, is associated with high mortality rates and long-term complications. In neonates, it mainly occurs as a complication of neonatal sepsis and meningitis. This case series reports three cases of neonatal brain abscesses involving infants who presented with fever and other symptoms and were treated with antibiotics, surgical evacuation, and prophylactic anti-epileptic treatment. Following treatment, all infants showed marked radiological improvement and reduced abscess size. In addition, pus culture, blood culture, and CSF analysis reports were typical. Despite the severe nature of the condition, all three infants recovered well and achieved appropriate developmental milestones.

OBSERVATIONS: Neonatal brain abscess should be suspected in neonates with sepsis or meningitis developing fever, poor feeding, seizures, or general deterioration of health despite treatment. It is most commonly caused by gram-negative bacteria. However, in many instances, like in our 3 cases, sterile fluid may be aspirated from a brain abscess, which is considered a good prognostic factor.

LESSONS: Early diagnosis of neonatal brain abscess with high clinical suspicion use of neuroradiological imaging and prompt treatment with sensitive antibiotics and neurosurgical interventions can improve the prognosis and reduce its complications.