Bacteriology of intracranial abscess in children

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Abstract
The bacteriological and clinical findings in 19 pediatric patients with intracranial abscess are presented. Ten children presented with subdural empyema and 9 had brain abscess. Sinusitis was present in 14 children and dental abscess in 2. The abscess was located in the frontal and parietal area in 7 instances each, and in the temporal area in 5. Anaerobic organisms alone were recovered in 12 (63%) of the patients (including 8 with subdural empyema and 4 with brain abscess), aerobic bacteria alone were present in 2 children (11%), and mixed aerobic and anerobic bacteria were present in 5 (26%) patients. There were 43 anaerobic isolates (2.3/specimen). The predominant anaerobes were anaerobic Gram-positive cocci (16 isolates), Bacteroides sp. (10, including 2 B. fragilis), Fusobacterium sp. (9 isolates) and Actinomyces sp. (5 isolates). A total of 8 aerobic isolates (0.4/specimen), including 5 Gram-positive cocci and 3 Haemophilus sp., were recovered. Antimicrobial therapy was administered to all patients. Five patients, 4 with sinusitis and subdural empyema and 1 with sinusitis and brain abscess, did not respond to antimicrobial therapy and aspiration of the abscess, and required surgical drainage of their inflamed sinuses. These findings indicate the major role of anaerobic organisms in the polymicrobial etiology of intracranial abscess in children.

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