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Brain Abscess

What is a brain abscess?

A brain abscess is an infection in your child's brain that stays within its own area. This might be in one or more areas in the brain. This condition may cause problems with how the brain and spinal cord function.

What causes a brain abscess?

The more common causes of a brain abscess in children are viruses, fungi, and bacteria. But bacteria are the most common cause. Bacteria and viruses can infect the brain in 3 ways:

  • Infection is spread from another area of infection in the body, usually from a nearby site. Typically, this might be an ear infection, sinus infection, or dental infection.

  • Infection is spread through the bloodstream from the lung or chest area.

  • Viruses or bacteria enter the brain directly through a wound in the head.

Your child is more likely to develop a brain abscess if he or she has:

  • Heart disease that is present from birth (congenital)

  • Meningitis

  • Long-term (chronic) middle ear and sinus infections

  • Dental or jaw infections

  • Infections of the face or scalp

  • Head injury or skull fracture

  • Traction. This is a medical device that uses pins or screws placed around the head to hold the head and neck areas still. It is used in a child who has a broken neck or for surgeries that need the head and neck to stay still.

  • Shunt infections. Shunts are devices used to drain extra cerebral spinal fluid.

  • Diabetes

  • Weakened immune system. This is when your child's body is less able to fight infection. Certain medicines and health conditions such as HIV can weaken the immune system. 

What are the symptoms of a brain abscess?

The following are the most common symptoms of a brain abscess. But symptoms may be slightly different for each child.

In babies and younger children

  • Fever

  • A full or bulging soft spot on the top of the head (fontanelle)

  • Sleepiness or less alert than usual

  • Increased irritability

  • High-pitched cry

  • Poor feeding

  • Projectile vomiting

  • Headache

  • Seizures

In older children

  • Fever

  • Complaints of severe headaches

  • Nausea and vomiting

  • Changes in personality or behavior

  • Changes in speech

  • Problems walking

  • Increased movement in the arms or legs (spasticity)

  • Seizures

The symptoms of a brain abscess may look like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is a brain abscess diagnosed?

Your child's healthcare provider will look at your child's health history and family health history. He or she will do a physical exam. The provider will measure around your child's head and compare that number with a scale that can shows normal and abnormal ranges. As the infection grows and becomes bigger, it can push on the brain. This may cause increased pressure inside of the head. This pressure can cause symptoms in your child.

Your child may also need tests. These may include:

  • Blood tests

  • X-ray. This test uses radiation to make pictures of your child's skull. A skull X-ray probably won't show a brain abscess, but it can show fractures that might lead to an abscess.

  • MRI. This test uses large magnets, radio waves, and a computer to make detailed images of organs and structures within the body. Your child may be given a contrast dye to better see the abscess.

  • CT scan. This test uses X-rays and a computer to make detailed images of the body. Your child may be given a contrast dye to better see the abscess.

  • Urine and stool tests

  • Sputum culture. This test looks at material that is coughed up from the lungs and into the mouth. This test is often done to find out if your child has an infection.

  • Lumbar puncture (spinal tap). This test uses a needle to help measure the pressure in the spinal canal and brain. The healthcare provider can also remove a small amount of cerebral spinal fluid (CSF) to send for testing. CSF is the fluid that bathes your child's brain and spinal cord. The fluid sample can help find out if your child has an infection or other problems. It is important to find out what kind of infection may be causing the abscess, because treatment differs depending on the cause. This test may not be done or may be delayed if your child has brain swelling or a shift in the brain tissue.

Treatment for a brain abscess

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

The key to treating a brain abscess is finding and treating it early. A child with a brain abscess needs to be put in the hospital right away. The healthcare provider will give your child antibiotics and watch your child closely. Your child may need surgery.

The goal of treatment is to reduce the pressure in the head and to properly drain the infection. Medicines are used to control the infection, seizures, fever, and other conditions that may be present. Other organs may be affected by the brain abscess. In severe cases, your child may need a breathing machine to help him or her breathe easier.

As your child recovers, he or she may need physical, occupational, or speech therapy. This will help your child regain muscle strength, speech skills, or both.

Your child's healthcare team will help you learn how to best care for your child at home. They will tell you what problems to watch for that need medical attention right away. Your child will need to see his or her healthcare provider often after treatment ends.

Online Medical Reviewer: Fetterman, Anne, RN, BSN
Online Medical Reviewer: Shelat, Amit, MD
Date Last Reviewed: 11/1/2016
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