Intracranial abscesses in children at Ile-Ife, Nigeria: a case series and review of literature
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ORIGINAL ARTICLE
Intracranial abscesses in children at Ile-Ife, Nigeria: a case series and review of literature Oluwatosin E. Olorunmoteni 1 & Chiazor U. Onyia 2 & Jerome B. E. Elusiyan 1 & Osagie J. Ugowe 3 & Toluwani E. Babalola 3 & Ibitoye Samuel 4 Received: 10 January 2019 / Accepted: 31 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Central nervous system (CNS) infections are significant causes of morbidities and mortalities in children with some being prone to the development of abscesses which can either be within the brain parenchyma or located in extracranial structures. We aimed to describe the clinical profile and outcome of children with cranial abscesses at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC). Methods Consecutive cases presenting at the Children Emergency Ward of OAUTHC Ile-Ife were recruited. The pattern of presentation, predisposing factors and outcome of these children were studied. Results Among the 641 children admitted within a 6-month period, six were diagnosed with cranial abscess giving a hospital prevalence of 0.9%. The mean duration of symptom prior to presentation was 12.7 ± 13.4 days. Five (83.3%) of the patients had intracranial abscesses which were multiple in two (33.3%) children. One patient had Pott’s puffy tumour following frontal sinusitis. Surgical management was done for two (33.3%), and this was by craniotomy and evacuation. Two of the patients died with a case fatality rate of 33.3%. Conclusion Though uncommon, cranial abscesses remain life threatening in children especially in resource-poor settings. Early presentation and early treatment of local infections will improve outcome. Keywords Brain abscess . Pott’s puffy tumour . Children
Introduction Abscess formation within cranial structures occurs either intracranially and extracranially though the most common form is brain abscess [1]. Brain abscess is regarded as a significant life-threatening infection in children [2]. It often results from a direct spread of infection from contiguous structures or haematogenous spread from infections
* Oluwatosin E. Olorunmoteni [email protected] 1
Department of Paediatrics and Child Health, Obafemi Awolowo University (OAU), Ile-Ife, Nigeria
2
Neurosurgery Unit, Department of Surgery, Lagoon Hospitals, Lagos, Nigeria
3
Department of Paediatrics, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Nigeria
4
Department of Paediatrics, Federal Medical Centre, Owo, Nigeria
occurring at distant sites [2–4]. Thus, the risk factors for brain abscess include infections of contiguous structures like sinusitis, chronic suppurative otitis media, mastoiditis, soft tissue infections of the face and scalp, dental infections, orbital cellulitis, penetrating head trauma, cyanotic congenital heart diseases, lung infections and central nervous system (CNS) infections such as meningitis etc. [2–4]. However, in some patients, no exact source of infection can be identified [5]. The aetiologic agents for
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