The role of socioeconomic position in use of systemic anticancer therapy.

Inflammatory biomarkers refine progression risk stratification in NSCLC patients with stable disease.

To examine the clinical characteristics of sintilimab-induced myocarditis and to provide evidence for its diagnosis and management. Retrospective analysis was conducted on clinical case reports of sintilimab-induced myocarditis documented before July 31, 2025. A total of 34 patients were included, with a median age of 64 years (range: 33-85), including 23 (67.6%) male cases. The onset of myocarditis ranged from 1 to 120 days post-treatment, with a median onset of 21 days. The primary clinical presentations included dyspnea (41.2%), chest tightness (35.3%), palpitations (17.6%), and shortness of breath (14.7%), with some cases remaining asymptomatic (8.8%). Comorbid immune-related adverse events included myasthenia gravis (44.1%), myositis (17.6%), and hepatitis (17.6%). Laboratory findings often revealed elevated cardiac troponin I, N-terminal probrain natriuretic peptide, creatine kinase MB, and lactate dehydrogenase. The electrocardiogram mainly showed atrioventricular block (41.2%), ST-T segment changes (44.1%), and atrial or ventricular arrhythmias (50.0%). Echocardiography examination can show normal (34.5%), left ventricular diastolic dysfunction (31.0%), left atrial enlargement (13.8%), and pericardial effusion (13.8%). Cardiac magnetic resonance imaging may show normal (42.9%), myocardial edema (28.6%), and delayed myocardial enhancement (28.6%). Coronary angiography showed normal (73.3%) and coronary artery stenosis of the lumen (26.7%). All patients discontinued sintilimab and received steroid and intravenous immunoglobulin treatment. Outcomes indicated that 79.4% recovered from myocarditis, while 20.6% succumbed. Sintilimab-induced myocarditis has nonspecific manifestations and a high mortality rate. Myasthenia gravis and myositis can occur simultaneously with myocarditis. During simtimab treatment, it is necessary to closely monitor cardiac parameters and symptoms.

The goal of intrapartum management of diabetes is to keep maternal blood glucose within a certain range in order to reduce the risk of maternal complications as well as decrease the risk of neonatal hypoglycemia. Several protocols are available for intrapartum management and focus on using insulin drips and glucose-containing fluids to keep maternal blood glucose within a certain range. Similarly, there are many protocols for treating diabetic ketoacidosis, all of which address volume depletion, acidosis, and electrolyte imbalances with isotonic intravenous fluids, insulin, electrolyte replacement, and treatment of the underlying cause of ketosis.

Infective endocarditis (IE) is a life-threatening infection traditionally treated with 4-6 weeks of intravenous (IV) antibiotics. Emerging data, including the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial and recent meta-analyses, suggest that selected clinically stable patients can safely transition early to oral regimens, but practical guidance on implementation is limited. We conducted a comprehensive narrative review of randomized trials, observational studies, ongoing clinical trials, meta-analyses, and contemporary guidelines addressing partial oral antibiotic therapy in adult IE. Evidence consistently shows that after at least 10 days of effective IV treatment, patients who are afebrile, hemodynamically stable, have negative blood cultures, and no uncontrolled infection on imaging can be transitioned to dual oral regimens with high bioavailability and pathogen-directed activity. In this population, oral step-down therapy yields similar rates of death, relapse, embolic events, and unplanned cardiac surgery compared with prolonged IV therapy, while substantially reducing hospital length of stay and line-related complications. Data in people who inject drugs, those with multidrug-resistant pathogens, or severe heart failure remain limited, and robust pharmacokinetic validation of some oral β-lactam-based combinations is still needed. Overall, partial oral antibiotic therapy represents a safe, evidence-based, and stewardship-aligned strategy for many patients with left-sided native or prosthetic valve IE when applied within structured protocols and strict selection criteria.

Dialister pneumosintes(D. pneumosintes) is a slow-growing, obligate anaerobic Gram-negative bacillus commonly found in the oral cavity, nasopharynx, gastrointestinal tract, and vaginal microbiota. Although typically associated with periodontal disease, D. pneumosintes has rarely been implicated in bloodstream infections and, to date, has not been reported as a causative agent of meningitis. This case report describes D. pneumosintes bacteremia complicated by meningitis, highlighting the diagnostic challenges associated with fastidious anaerobes and the role of advanced microbiological techniques, including matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and 16S rRNA gene analysis, in accurate pathogen identification. A 65-year-old woman presented with fever, dysarthria, and posterior neck pain. Clinical examination revealed altered consciousness, restricted neck mobility, bilateral eyelid edema, and nasal speech. Laboratory findings indicated hypokalemia and metabolic alkalosis. Imaging studies revealed marked mucosal thickening and fluid accumulation in the paranasal sinuses, suggesting sinusitis with possible extension to the middle ear. Lumbar puncture before initiation of antibiotic therapy revealed neutrophilic pleocytosis consistent with acute bacterial meningitis. Blood cultures grew Staphylococcus hominis and an unidentified anaerobic Gram-negative bacillus, which was later identified as D. pneumosintes using MALDI-TOF MS. Empirical antibiotic therapy with ceftriaxone, vancomycin, ampicillin, and corticosteroids was initiated. Persistent fever prompted endoscopic sinus surgery on hospital day 5, with intraoperative cultures yielding Staphylococcus aureus and revealing a benign nasal papilloma. Neurological symptoms improved postoperatively. The patient completed 14 days of intravenous antibiotic treatment and was ultimately discharged on day 45. This is an exceptionally rare case of D. pneumosintes bacteremia complicated by meningitis. Given its propensity to originate from odontogenic or sinonasal infections and cause hematogenous dissemination with invasive complications such as abscesses or septic thrombosis, prompt identification is essential. When detected, clinicians should initiate a comprehensive systemic evaluation and consider surgical intervention as part of the treatment strategy. As advanced diagnostic tools such as MALDI-TOF MS and 16S rRNA gene sequencing become more widely available, increased clinical recognition of D. pneumosintes as a potential pathogen in severe anaerobic infections is warranted. Not applicable.

The aim of this study was to compare a normal saline bolus versus epinephrine during resuscitation on mortality and brain injury assessed by magnetic resonance spectroscopy (MRS) in newborn piglets. Thirty-two newborn piglets were subjected to hypoxic cardiac arrest and randomized to resuscitation with epinephrine (0.01 mg/kg, n = 16) or saline bolus (0.9%, 10 mL/kg, n = 16). A sham group received no intravenous treatment (n = 8). Brain MRS and magnetic resonance imaging (MRI) were performed 18 h after resuscitation. The primary outcome was a composite of death or severe brain damage determined by MRS. Secondary outcomes were mortality, time to return of spontaneous circulation (ROSC), and MRI/MRS measures of brain injury. There was no difference between piglets resuscitated with saline bolus vs. epinephrine in the primary outcome (RR: 0.94, 95% CI: 0.56, 1.58). The two groups were also similar with regards to mortality, time to ROSC, and MRS/MRI-outcomes. Sham piglets had a higher mortality (RR: 1.50, 95% CI: 0.88, 2.55) than intravenous treatment groups, although not statistically significant. Saline bolus during resuscitation was as effective as epinephrine in preventing death and brain injury, as determined by MRS. Saline bolus may be a relevant alternative to epinephrine during neonatal resuscitation. Saline bolus is as effective as epinephrine in achieving return of spontaneous circulation in newborn piglets with hypoxic cardiac arrest. Saline bolus and epinephrine result in similar brain outcomes measured by magnetic resonance spectroscopy at 18 h. Saline bolus and epinephrine achieve similar time to return of spontaneous circulation and 18-h survival. This study adds to the limited evidence regarding the effect of saline volume expansion during neonatal resuscitation and underlines the need for clinical trials.

Background and purposeAlthough systolic blood pressure variation (ΔSBP) has been regarded as a predictor of poor outcome after endovascular therapy (EVT), its effect at the different time intervals on the prognosis of acute anterior large vessel occlusion remains unclear. The study aims to assess the impact of ΔSBP at different time intervals on futile recanalisation (FRT) of acute anterior circulation large-vessel occlusion stroke after EVT.MethodsA total of 554 consecutive patients who achieved successful recanalisation after EVT were enrolled from the Effect of Endovascular Treatment Alone versus Intravenous Alteplase Plus Endovascular Treatment on Functional Independence in Patients with Acute Ischemic Stroke (DEVT) and Effect of Intravenous Tirofiban versus Placebo Before Endovascular Thrombectomy on Functional Outcomes in Large Vessel Occlusion Stroke (RESCUE BT) trials. ΔSBP was defined as SBP max minus SBP min at different time intervals, including 0–6 hours, 6–12 hours and 12–24 hours after EVT. The primary outcome was FRT at 90 days, defined as a modified Rankin Scale score of 3 to 6. The secondary outcome was symptomatic intracranial haemorrhage within 48 hours.ResultsAmong these patients, 278 patients underwent FRT and 276 achieved useful recanalisation at 90 days. ΔSBP 0–6 hours was found to be positively associated with an increased likelihood of FRT (adjusted OR (aOR) per 5 mm Hg SBP change, 1.014, 95% CI 1.002 to 1.026). Large variation of SBP (ΔSBP >40 mm Hg) in the first 6 hours had a higher probability of FRT (aOR, 1.817, 95% CI 1.059 to 3.117) compared with a ΔSBP of 0–20 mmHg.ConclusionSBP variation within the first 6 hours after EVT was associated with FRT. Large fluctuations (ΔSBP >40 mm Hg) of SBP in 0–6 hours following EVT were found to increase the probability of FRT.

Lifileucel is a tumor-derived autologous T cell therapy approved for unresectable or metastatic melanoma in adults. This article discusses 10 clinical studies on lifileucel for the treatment of advanced melanoma. The phase II study data available evaluated the safety and efficacy of lifileucel in a global, multicenter study involving adult patients with unresectable or metastatic melanoma who had previously received systemic therapies, including a PD-1 blocking antibody and, if applicable, BRAF and MEK inhibitors. Among 73 patients treated with the recommended dose, the objective response rate was 31.5%, with 4.1% achieving a complete response and 27.4% a partial response. Of the responders, 56.5%, 47.8%, and 43.5% maintained their responses without progression or death at 6, 9, and 12 months, respectively. The most common adverse events seen in clinical studies include thrombocytopenia, anemia, and febrile neutropenia. Additional studies are underway to provide further data on the use of lifileucel as a safe and effective intravenous treatment option for unresectable or metastatic melanoma. This article reviews the published data encompassing the preliminary development, pharmacology, efficacy, and safety of lifileucel.

Spinal infection: an evolving clinical and public health challenge.

Background/Objectives: Disease-related malnutrition is highly prevalent in oncology and is associated with poor clinical outcomes. Early detection through nutritional screening is essential; however, the optimal screening tool for ambulatory cancer patients remains uncertain. This study aimed to evaluate the agreement and diagnostic performance of the malnutrition screening tool (MST) and NUTRISCORE compared with the Global Leadership Initiative on Malnutrition (GLIM) criteria in a large nationwide cohort of ambulatory cancer patients. Methods: In this multicenter, observational, cross-sectional nationwide study, adult patients attending oncology day hospitals for intravenous antineoplastic treatment between April and November 2021 were included. Nutritional risk was assessed using MST (cut-off ≥ 2) and NUTRISCORE (cut-off ≥ 5). Malnutrition was diagnosed according to GLIM criteria. Agreement between tools was assessed with Cohen’s kappa, and diagnostic performance was evaluated by sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. Analyses were stratified by tumor nutritional risk and cancer stage. Results: Among 4440 patients from 86 hospitals, 50.7% met the GLIM criteria for malnutrition; 72.5% had moderate and 27.5% severe malnutrition. MST identified 37.5% of patients as being at nutritional risk, compared with 17.3% identified by NUTRISCORE. Agreement between MST and NUTRISCORE was moderate overall (κ = 0.48; 95% CI, 0.45–0.51), but varied markedly according to tumor nutritional risk, ranging from high agreement in high-risk tumors (κ = 0.82) to low agreement in low-risk tumors (κ = 0.28). Relative to GLIM, MST was more sensitive than NUTRISCORE (0.51 vs. 0.27), whereas NUTRISCORE was more specific (0.92 vs. 0.76) and had a higher positive predictive value (0.77 vs. 0.68). Negative predictive value was low for both tools. Conclusions: GLIM-defined malnutrition was highly prevalent in this large cohort of ambulatory patients with cancer. MST provided greater case detection, whereas NUTRISCORE showed a more conservative profile with higher specificity but substantially lower sensitivity. These findings suggest that the choice of screening tool should consider clinical context- and tumor-related nutritional risk, and that neither instrument alone reliably excludes malnutrition in outpatient oncology settings.

Heart failure is a common complication after acute myocardial infarction (AMI). However, the prognostic impact of patterns of heart failure management during hospitalization remains unclear. This multicenter, retrospective study included 2426 patients with AMI undergoing percutaneous coronary intervention. Patients were categorized into three groups: no intravenous (i.v.) heart failure treatment (patients received neither i.v. diuretics nor inotropes/vasopressors), diuretics only (diuretics without inotropes/vasopressors), and inotropes (inotropes/vasopressors with or without diuretics) groups. The primary endpoints included all-cause death during hospitalization and a composite of all-cause death and heart failure rehospitalization after discharge. Overall, 646 patients (26.6%) developed in-hospital heart failure. During hospitalization, the mortality rate was higher in the inotropes group (34.9%), followed by the diuretics only group (5.9%) and the no i.v. heart failure treatment group (2.2%) (P < 0.001). During a median follow-up of 535 days, 196 (9.7%) patients developed the primary endpoint after discharge. A composite of all-cause death and heart failure rehospitalization occurred in 6.5% of the no i.v. heart failure treatment group, while those in the diuretics group (21.2%) and inotropes group (24.3%) had a similar risk of the primary endpoint. Heart failure events requiring i.v. treatments during hospitalization were associated with an increased in-hospital mortality, particularly in those treated with inotropes in patients with AMI. Among patients who were discharged alive, however, long-term outcomes did not differ significantly between patients treated with diuretics only and inotropes.

Seasonal influenza is a widespread acute respiratory infection that causes significant illness and death worldwide. Two major antiviral classes are neuraminidase inhibitors (NAIs) and polymerase inhibitors. NAIs, including oseltamivir, zanamivir, peramivir and laninamivir, block viral release, while polymerase inhibitors such as baloxavir disrupt viral RNA replication. Early administration within 48 h of symptom onset reduces illness duration, severity and complications, particularly in high-risk groups. Oseltamivir is the most widely studied NAI, demonstrating reduced viral shedding, faster symptom resolution and lower complication rates, though gastrointestinal side effects are common. Higher doses generally do not improve outcomes compared to standard dosing. Zanamivir is more effective against influenza B and is inhibitory for most influenza A viruses resistant to oseltamivir, but the inhaled formulation is less suitable for patients with severe illness or airway disease. Intravenous (IV) zanamivir is approved for hospitalized influenza patients in some countries. Peramivir offers IV treatment options, while laninamivir is mainly used in Japan. Baloxavir shows superior viral load reduction and comparable symptom relief to oseltamivir in outpatients, though resistance variants can emerge. Favipiravir and newer polymerase inhibitors are under investigation. Combination therapies may enhance recovery, with limited evidence. Overall, timely antiviral use is critical to reducing influenza's burden. This article is part of the Theo Murphy meeting issue 'Evaluating anti-infective drugs'.

The incidences of herpes zoster, osteoporotic vertebral compression fractures, and infectious spondylitis is increasing worldwide owing to the aging population. Given the potential for multiple comorbid conditions with overlapping clinical presentations, thorough history-taking and physical examination are essential for accurate diagnoses. However, the coexistence of herpes zoster, osteoporotic vertebral compression fractures, and infectious spondylitis in a single patient is exceedingly rare, making timely diagnosis even more challenging. A 64-year-old woman with a medical history of hypertension, asthma, and right-sided hemiplegia secondary to a previous hemorrhagic stroke presented with painful vesicular lesions in the right T10 dermatome consistent with herpes zoster. Despite antiviral and antibiotic therapy, her pain worsened, and inflammatory markers increased significantly. Physical examination revealed midline spinal tenderness and pain, exacerbated by postural changes. Magnetic resonance imaging confirmed a collapsed L3 vertebral body consistent with Kummell's disease, along with paravertebral soft tissue changes and psoas muscle involvement, suggesting coexisting infectious spondylitis. Although the biopsy cultures were negative, empirical intravenous cefazolin therapy was initiated. After 2 weeks of intravenous antibiotic treatment, the C-reactive protein and procalcitonin levels normalized. Given the persistent mechanical back pain and stabilized infection, a vertebroplasty was performed. After the vertebroplasty, the patient experienced rapid pain relief without any signs of recurrent infection. Following a 5-week course of intravenous antibiotic therapy and an additional 2 months of oral administration, the patient achieved complete clinical resolution with full remission of both infectious manifestations and zoster-associated sequelae. This case underscores the importance of a comprehensive clinical assessment in older patients, even when a diagnosis of herpes zoster is apparent. Persistent or atypical symptoms warrant further evaluation to exclude concurrent diseases. Furthermore, vertebroplasty can be safely performed in select patients with infectious spondylitis following adequate antibiotic therapy, leading to pain reduction. A multidisciplinary, individualized approach is essential to achieve optimal outcomes in patients with complex spinal pathologies.

Effects of vatinoxan in horses sedated with detomidine and butorphanol for gastroscopy: A randomized clinical study.

Mechanical thrombectomy is the gold standard in acute ischaemic stroke management; however, intravenous thrombolysis remains essential, particularly in settings without access to endovascular therapy. Given its ongoing relevance, we aimed to investigate the age-related clinical, radiological and procedural factors affecting outcomes after intravenous thrombolysis. We retrospectively evaluated patients who had acute neurological deficits within the first 4.5 h after the onset of symptoms and were given intravenous tissue plasminogen activator therapy. Patients were divided into three groups according to their age: <55, 55-75 and >75 years. A modified Rankin Scale 0-2 was considered as a good functional outcome. A total of 432 patients were included in the study, of whom 196 (45.1%) were women. The prevalence of diabetes mellitus (DM) and hypertension increased with age, while smoking was more frequent in patients aged <55 years. Atrial fibrillation was significantly more common in patients aged >75 years. In the >75 years age group, admission National Institutes of Health Stroke Scale (NIHSS) scores were higher ( P = 0.042). The proportion of patients with poor clinical outcomes also increased progressively across the three age groups. This study underscores age as a key predictor of outcomes following intravenous thrombolysis in acute ischaemic stroke. Among patients aged >75 years, prolonged symptom-to-needle time, atrial fibrillation, higher baseline NIHSS and DM were significantly associated with poor clinical outcomes. Younger patients demonstrated more favourable recovery profiles, whereas advancing age was associated with higher mortality. Notably, DM consistently emerged as a risk factor for unfavourable outcomes across all age groups.

Facioscapulohumeral muscular dystrophy (FSHD) is an autosomal dominant muscular disease in which genetic mutations activate DUX4 expression in skeletal muscle. Currently, there are no approved therapies for FSHD. We developed Delpacibart braxlosiran (del-brax, also known as AOC 1020), an antibody oligonucleotide conjugate (AOC), for the treatment of FSHD that is designed to specifically target and reduce DUX4 mRNA in skeletal muscle. AOC 1020 is composed of DUX4 mRNA-targeting small interfering RNA (siRNA), siDUX4.6, conjugated to a human transferrin receptor 1 (TfR1)-targeting monoclonal antibody to facilitate productive siRNA delivery to muscle. We demonstrate that siDUX4.6 reduces DUX4-regulated gene expression in FSHD patient-derived myotubes in vitro and in skeletal muscle of the ACTA1-MCM; FLExDUX4 FSHD mouse model in vivo. Single systemic intravenous treatment was sufficient to prevent DUX4-induced muscle weakness and fibrosis in this FSHD mouse model and reduce DUX4-regulated genes by ∼75% 8 weeks post-dose. The pharmacokinetic profiles of AOCs with siDUX4.6 were comparable in murine and non-human primate muscle. These data demonstrate the potential of AOC 1020 to treat the underlying cause of FSHD by suppressing DUX4 expression in muscles of patients with FSHD. The safety and efficacy of AOC 1020 is currently being investigated in clinical trials.

Background/Objectives: Fibromyalgia is a painful syndrome with biopsychosocial components that predominantly affects middle-aged women. This study aimed to evaluate changes in sleep quality and quality of life following intravenous (IV) lidocaine treatment in patients with fibromyalgia (FM). Methods: This retrospective observational study included patients diagnosed with fibromyalgia who underwent intravenous lidocaine treatment at a tertiary pain clinic between June 2023 and June 2024 and had a Pittsburgh Sleep Quality Index (PSQI) score > 5. The patients' demographic data, Fibromyalgia Impact Questionnaire (FIQ) scores at baseline and at 1 and 3 months post-treatment, Numerical Rating Scale (NRS-11) scores, Short Form-12 (SF-12) mental and physical component scores (MCS-12, PCS-12), and PSQI scores were recorded. Results: Overall, 51 patients were included. 92.2% of the patients were women, with a mean age of 41.6 ± 9.5 years. Statistically significant reductions in NRS-11, FIQ, and PSQI scores and increases in SF-12 component scores were observed at 1 and 3 months compared with baseline (p < 0.001). Negative correlations were found between NRS-11 and PCS-12 and MCS-12, and a positive correlation was found between FIQ and PSQI. Sleep quality showed a marked improvement at 1 month; however, attenuation of this benefit was observed at the 3-month follow-up. Conclusions: Sleep quality appeared to be associated with short-term functional outcomes, whereas pain intensity was associated with mid-term clinical status in patients with fibromyalgia. Prospective randomized controlled trials are required to confirm these findings and to determine optimal dosing and treatment schedules.

Pediatric acute-onset neuropsychiatric syndrome (PANS) is characterized by abrupt-onset neuropsychiatric symptoms, often infection-triggered. Intravenous immunoglobulin (IVIG) is recommended by expert guidelines in select cases, yet insurance denials and high out-of-pocket costs have been barriers to access. We surveyed 60 caregivers and adult PANS patients who pursued IVIG therapy, collecting data on insurance coverage, treatment protocols, financial strategies, and quality of life (QoL) before and after treatment. Most patients (88%) eventually received IVIG, 10% were still in pursuit, and 2% discontinued trying. Insurance approval without appeal occurred for 24%, often for patients with comorbidities for which IVIG is typically covered. Only 5% of those receiving IVIG for PANS alone were treated within a month of the doctor's order compared with 38% of those receiving IVIG for comorbidities plus PANS; 14% waited ≥9 months. Financial strain was routine: at least one-third of families without "substantial" insurance coverage (≥70% of expenses) reported extreme stress (10 on scale of 1 to 10), 58% borrowed money, and 21% sold major assets. Even families with substantial insurance coverage commonly depleted savings or took on additional work. Before IVIG, patient QoL ratings were poor (means 2.1-2.9 across domains), with over one-third selecting the lowest possible overall QoL rating. During the 6 months following IVIG initiation, mean ratings rose to 6.2-6.8, with over 60% reporting "good" to "exceedingly good" overall outcomes. Caregivers reported parallel gains, with family QoL ratings rising from 2.4-4.0 pretreatment to 5.7-6.6 posttreatment. Families pursuing IVIG for PANS reported prolonged delays, repeated denials, and financial strain, often resorting to loans, asset sales, and additional work. Despite these burdens, IVIG was correlated with marked improvements in perceived QoL for patients and caregivers.

Brain abscesses and intracranial empyemas are rare but serious infections associated with substantial morbidity and long-term neurologic sequelae. Microbiologic confirmation is often limited by prior empirical therapy, and the diagnostic yield of real-time polymerase chain reaction in real-world settings remains uncertain. Evidence guiding antimicrobial duration, microbiologic work-up and radiologic follow-up in children is limited. We aimed to describe a pediatric cohort, focusing on management strategies, molecular diagnostics and radiologic follow-up. In this single-center study, we reviewed the clinical charts of a tertiary care pediatric hospital in Italy from 2017 to 2025. Children younger than 18 years diagnosed with brain abscess or subdural/epidural empyema were included. Clinical, radiologic, microbiologic, and immunologic treatment and outcome data were collected. Comparisons were performed using the Mann-Whitney U test and Fisher exact test. The study cohort included 26 children (17 brain abscesses, 7 subdural empyemas and 2 epidural empyemas). Pathogens were identified in 21 patients (81%), with 23 isolates. Real-time polymerase chain reaction exclusively detected 43% of isolates (10/23). Half of patients received <6 weeks of intravenous therapy without recurrence, including 35% of brain abscesses. Children undergoing drainage/craniotomy had larger lesions ( P = 0.04) and required longer intravenous treatments than those managed conservatively (42 vs. 20 days, P = 0.022). Radiologic follow-up showed residual findings in most cases (60%). One child died; neurologic sequelae occurred in 15% of cases. Pediatric intracranial abscesses require intensive multidisciplinary care, with marked heterogeneity in current treatment strategies. Molecular testing substantially enhances diagnostic yield and pathogen identification. Radiologic structural sequelae are common, but their prognostic significance remains unclear. Standardized pediatric protocols and well-designed prospective studies are needed to optimize antimicrobial stewardship, define which candidates may safely receive shorter intravenous courses, and harmonize follow-up imaging.