Background: Congenital heart disease is a malformation which the prevalence of 8 \ufffd?among alive infants. If it is not being treated on time, these malformations will develop to severe complication. The most common cause of cerebral abscess is congenital heart disease in infants. Objectives:This study aims to learn about some related factors and close consequence of cerebral abscess in congenital cardiac children. Subjects and method:A retrospective and prospective study was conducted on 37 patients with congenital heart disease were suffered from a cerebral abscess since January 2001 to 31 March 2007. Results:The boys were dominant with sex ratio: 1.85/1. Average age of acquired abscess was 6.8 years, 34/37 (91.9%) patients had curable congenital heart disease, including 33/37 (89.2%) diagnosed of right-left shunt. In comparison with patients whom over 2 years old and did not acquire abscess due to congenital cardiac shunt right-left type, there was no significant difference in hemoglobin, hematocrit, erythrocyte and saturation cutannee 13.5% among 37 patients of study were deaths, 26.5% had neurological sequelae and 8.1% were relapses. The average duration of hospitalization was longer (25.7 days) and the average costs were 4,317,000 Vietnam dong. Conclusion: Cerebral abscess was late complication of congenital heart disease and it was very necessary to treat completely the malformation of congenital heart disease in order to prevent of severe complication.
Heart Defects ; Congenital/ epidemiology ; therapy ; Brain Abscess/ epidemiology

BACKGROUND: Brain abscess is a important infectious disease of the central nervous system, although the mortality has been reduced due to new antibiotics therapy and improved imaging techniques. MATERIALS amp; METHODS: Over a period of 17 years, from March 1986 to Feburary 2003, 110 patients were identified as having brain abscess at the Severance Hospital. Based on medical records, we reviewed these cases and investigated retrospectively the epidemiology, clinical findings, therapeutic modalities and prognostic factors of brain abscess. RESULTS: There were 78 males and 32 females, and the mean age was 34.4 years. The most common location of brain abscess was the parietal lobe (24.5%), followed by temporal (20.9%) and frontal lobes (20.0%). Gram positive cocci were most frequently isolated as the causative microorganism. Tuberculous brain abscess were diagnosed in 6 (8.8%) cases. The common predisposing conditions were neurosurgery (21.8%), otitis media (10%) and congenital heart disease (8.2%). Headache (63.6%), fever (55.5%) and focal neurologic deficits (51.8%) were the common symptoms. Aspiration or open drainage was performed in 77 cases (70.0%), and excision was performed in 17 cases(15.5%). Thirty five (31.9%) patients had neurologic sequelae after treatment, and the mortality rate was 11.8%. Factors influencing mortality of brain abscess were mental status and multiple abscesses. CONCLUSION: Brain abscess is still a critical infectious disease of the central nervous system with high mortality and morbidity in Korea. Active surgical procedures including aspiration, open drainage or excision, as well as antibiotic therapy, are needed for the proper management.
Abscess ; Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Central Nervous System ; Communicable Diseases ; Drainage ; Epidemiology ; Female ; Fever ; Frontal Lobe ; Gram-Positive Cocci ; Headache ; Heart Defects, Congenital ; Humans ; Korea ; Male ; Medical Records ; Mortality ; Neurologic Manifestations ; Neurosurgery ; Otitis Media ; Parietal Lobe ; Retrospective Studies

BACKGROUND: Brain abscess is a important infectious disease of the central nervous system, although the mortality has been reduced due to new antibiotics therapy and improved imaging techniques. MATERIALS amp; METHODS: Over a period of 17 years, from March 1986 to Feburary 2003, 110 patients were identified as having brain abscess at the Severance Hospital. Based on medical records, we reviewed these cases and investigated retrospectively the epidemiology, clinical findings, therapeutic modalities and prognostic factors of brain abscess. RESULTS: There were 78 males and 32 females, and the mean age was 34.4 years. The most common location of brain abscess was the parietal lobe (24.5%), followed by temporal (20.9%) and frontal lobes (20.0%). Gram positive cocci were most frequently isolated as the causative microorganism. Tuberculous brain abscess were diagnosed in 6 (8.8%) cases. The common predisposing conditions were neurosurgery (21.8%), otitis media (10%) and congenital heart disease (8.2%). Headache (63.6%), fever (55.5%) and focal neurologic deficits (51.8%) were the common symptoms. Aspiration or open drainage was performed in 77 cases (70.0%), and excision was performed in 17 cases(15.5%). Thirty five (31.9%) patients had neurologic sequelae after treatment, and the mortality rate was 11.8%. Factors influencing mortality of brain abscess were mental status and multiple abscesses. CONCLUSION: Brain abscess is still a critical infectious disease of the central nervous system with high mortality and morbidity in Korea. Active surgical procedures including aspiration, open drainage or excision, as well as antibiotic therapy, are needed for the proper management.
Abscess ; Anti-Bacterial Agents ; Brain Abscess* ; Brain* ; Central Nervous System ; Communicable Diseases ; Drainage ; Epidemiology ; Female ; Fever ; Frontal Lobe ; Gram-Positive Cocci ; Headache ; Heart Defects, Congenital ; Humans ; Korea ; Male ; Medical Records ; Mortality ; Neurologic Manifestations ; Neurosurgery ; Otitis Media ; Parietal Lobe ; Retrospective Studies

Objective: To analyze the clinical epidemiological characteristics including composition of pathogens , clinical characteristics, and disease prognosis acute bacterial meningitis (ABM) in Chinese children. Methods: A retrospective analysis was performed on the clinical and laboratory data of 1 610 children <15 years of age with ABM in 33 tertiary hospitals in China from January 2019 to December 2020. Patients were divided into different groups according to age,<28 days group, 28 days to <3 months group, 3 months to <1 year group, 1-<5 years of age group, 5-<15 years of age group; etiology confirmed group and clinically diagnosed group according to etiology diagnosis. Non-numeric variables were analyzed with the Chi-square test or Fisher's exact test, while non-normal distrituction numeric variables were compared with nonparametric test. Results: Among 1 610 children with ABM, 955 were male and 650 were female (5 cases were not provided with gender information), and the age of onset was 1.5 (0.5, 5.5) months. There were 588 cases age from <28 days, 462 cases age from 28 days to <3 months, 302 cases age from 3 months to <1 year of age group, 156 cases in the 1-<5 years of age and 101 cases in the 5-<15 years of age. The detection rates were 38.8% (95/245) and 31.5% (70/222) of Escherichia coli and 27.8% (68/245) and 35.1% (78/222) of Streptococcus agalactiae in infants younger than 28 days of age and 28 days to 3 months of age; the detection rates of Streptococcus pneumonia, Escherichia coli, and Streptococcus agalactiae were 34.3% (61/178), 14.0% (25/178) and 13.5% (24/178) in the 3 months of age to <1 year of age group; the dominant pathogens were Streptococcus pneumoniae and the detection rate were 67.9% (74/109) and 44.4% (16/36) in the 1-<5 years of age and 5-<15 years of age . There were 9.7% (19/195) strains of Escherichia coli producing ultra-broad-spectrum β-lactamases. The positive rates of cerebrospinal fluid (CSF) culture and blood culture were 32.2% (515/1 598) and 25.0% (400/1 598), while 38.2% (126/330)and 25.3% (21/83) in CSF metagenomics next generation sequencing and Streptococcus pneumoniae antigen detection. There were 4.3% (32/790) cases of which CSF white blood cell counts were normal in etiology confirmed group. Among 1 610 children with ABM, main intracranial imaging complications were subdural effusion and (or) empyema in 349 cases (21.7%), hydrocephalus in 233 cases (14.5%), brain abscess in 178 cases (11.1%), and other cerebrovascular diseases, including encephalomalacia, cerebral infarction, and encephalatrophy, in 174 cases (10.8%). Among the 166 cases (10.3%) with unfavorable outcome, 32 cases (2.0%) died among whom 24 cases died before 1 year of age, and 37 cases (2.3%) had recurrence among whom 25 cases had recurrence within 3 weeks. The incidences of subdural effusion and (or) empyema, brain abscess and ependymitis in the etiology confirmed group were significantly higher than those in the clinically diagnosed group (26.2% (207/790) vs. 17.3% (142/820), 13.0% (103/790) vs. 9.1% (75/820), 4.6% (36/790) vs. 2.7% (22/820), χ²=18.71, 6.20, 4.07, all P<0.05), but there was no significant difference in the unfavorable outcomes, mortility, and recurrence between these 2 groups (all P>0.05). Conclusions: The onset age of ABM in children is usually within 1 year of age, especially <3 months. The common pathogens in infants <3 months of age are Escherichia coli and Streptococcus agalactiae, and the dominant pathogen in infant ≥3 months is Streptococcus pneumoniae. Subdural effusion and (or) empyema and hydrocephalus are common complications. ABM should not be excluded even if CSF white blood cell counts is within normal range. Standardized bacteriological examination should be paid more attention to increase the pathogenic detection rate. Non-culture CSF detection methods may facilitate the pathogenic diagnosis.
Adolescent ; Brain Abscess ; Child ; Child, Preschool ; Escherichia coli ; Female ; Humans ; Hydrocephalus ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial/epidemiology* ; Retrospective Studies ; Streptococcus agalactiae ; Streptococcus pneumoniae ; Subdural Effusion ; beta-Lactamases