Unusual presentation of brain abscess in a 23-month-old infant.

BACKGROUD: Pediatric brain abscesses usually occur as a consequence of predisposing conditions, such as ENT (ear, nose, and throat) infection and physical damage. But there are still a number of cryptogenic infection cases.

METHODS

We present an unusual cryptogenic infection case of multiple and multiloculated brain abscess in an infant, which was in the absence of ENT infection, meningitis, trauma, prior surgery, cyanotic heart disease, or immune defect. The child has no specific symptoms but keeping apathic and days of diarrhea. Deduced from clinical presentation and this case's DWI-MRI features, the onset of infection is hematogenous route, and the diarrhea could be the possible inducement. The child was successfully treated by surgical excision of big lesions and an 8-week total course of intravenous antibiotics. At the end of the 1-year follow-up period, the infant is well at both of physical and mental health.

CONCLUSION

The interest of this case is the silent clinical presentation and the possibly rare precipitating factor. To a certain extent, the variation trend of blood C-reactive protein level could predict the clinical effect of antibiotics in brain abscess case.