Brain Abscess From a Peritonsillar Abscess in an Immunocompetent Child: A Case Report and Review of the Literature

Abstract A brain abscess is uncommon but potentially lethal. Common predisposing risk factors include congenital cyanotic heart disease, immunocompromised status, and the presence of septic foci. We describe a left frontal brain abscess accompanied by fever, headache, and weight loss for a 3-month p...

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Bibliographic Details
Published in:Pediatric neurology 2012-12, Vol.47 (6), p.451-454
Main Authors: Sankararaman, Senthilkumar, MD, Riel-Romero, Rosario Maria S., MD, Gonzalez-Toledo, Eduardo, MD, PhD
Format: Article
Language:English
Subjects:
Abscesses
Anti-Bacterial Agents - therapeutic use
Antibiotics
Bacteroidaceae Infections - drug therapy
Bacteroidaceae Infections - pathology
Bacteroidaceae Infections - surgery
Biological and medical sciences
Brain
Brain Abscess - drug therapy
Brain Abscess - etiology
Brain Abscess - pathology
Brain Abscess - surgery
Case reports
Central Nervous System Bacterial Infections - drug therapy
Central Nervous System Bacterial Infections - pathology
Central Nervous System Bacterial Infections - surgery
Child
Drainage
Female
Fever
Headache
Heart diseases
Humans
Hydrocephalus
Intravenous administration
Literature reviews
Magnetic Resonance Imaging
Medical sciences
Meninges
Neurology
Pediatrics
Peritonsillar Abscess - complications
Peritonsillar Abscess - pathology
Peritonsillar Abscess - surgery
Prevotella - isolation & purification
Risk factors
Skull
Tumors of the nervous system. Phacomatoses
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Summary:Abstract A brain abscess is uncommon but potentially lethal. Common predisposing risk factors include congenital cyanotic heart disease, immunocompromised status, and the presence of septic foci. We describe a left frontal brain abscess accompanied by fever, headache, and weight loss for a 3-month period. The presumptive source of the brain abscess involved a left peritonsillar abscess. To the best of our knowledge, one similar case was reported in the literature in 1929. The specific signs of peritonsillar abscess in our patient included trismus, decreased phonation, and a muffled voice. The peritonsillar abscess was not clinically diagnosed, but incidentally detected on lower axial sections of cranial magnetic resonance imaging. Fever and trismus improved after surgical drainage of the peritonsillar abscess. The cerebral abscess was conservatively treated with intravenous antibiotics. The patient developed hydrocephalus as a sequela to the involvement of the basal meninges.
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2012.08.014