Abstract

Introduction: Neonatal brain abscess is an uncommon intracranial suppuration that usually occurs as a complication of bacterial meningitis or septicaemia. Staphylococcus aureus rarely causes brain abscesses during the first months of life. Case presentation: A case of a premature infant who developed cerebellar, left temporal and left occipital lobe abscesses after S. aureus sepsis is presented. The pus provided the same S. aureus strain of the sepsis. The patient was treated with vancomycin for 37 days, accompanied by extraction of the purulent material. The abscesses resolved and no sequelae remained. Conclusion: It appears that long antibiotic treatment regimes, when associated with early pus drainage, are effective in resolving infection and abscesses caused by S. aureus in neonates.

Highlights

  • IntroductionNeonatal brain abscess is an uncommon intracranial suppuration that usually occurs as a complication of bacterial meningitis or septicaemia

  • Neonatal brain abscess is an uncommon intracranial suppuration that usually occurs as a complication of bacterial meningitis or septicaemia (Kao et al, 2008; Krajewski & Stelmasiak, 1992)

  • We present the clinical features, treatment and outcome of a premature infant with multiple brain abscesses caused by S. aureus

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Summary

Introduction

Neonatal brain abscess is an uncommon intracranial suppuration that usually occurs as a complication of bacterial meningitis or septicaemia (Kao et al, 2008; Krajewski & Stelmasiak, 1992). A 2-month-old male infant was admitted to the Neonatal Intensive Care Unit of the University Hospital of Asturias, Spain, with macrocephaly as the main clinical sign, which was accompanied by irritability, vomiting and inability to look upwards He had, normal tone and primitive reflexes, as well as good connection with the environment. The blood culture was positive for a coagulase-positive S. aureus strain, which was susceptible to penicillin G, oxacillin, vancomycin, co-trimoxazole, erythromycin and clindamycin Given these data, the treatment with vancomycin was continued, the trough levels being 8 mg ml. The patient was discharged in excellent condition at 50 days of age His physical parameters at that time were: weight, 2280 g (P3–10); length, 47 cm (P3) and head circumference, 35 cm (P75). At the 15-month follow-up visit, the child appeared to be healthy and was not showing any neurological or JMM Case Reports developmental sequelae: he walked without help, asked for objects by finger pointing, said ‘hello’ and ‘bye’, kissed, played with other children and made two-cube towers

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