Document Type : Case Report
Authors
1 Clinical Research Development Unit, Hazrat-e Fateme Masoume Hospital, University of Medical Sciences, Qom, Iran
2 Student Research Committee, Qom University of Medical Sciences, Qom, Iran
Abstract
Background: Brain abscess is a serious infection within the cranial space characterized by an encapsulated accumulation of purulent exudates. This report presents a case of a 14-day-old neonate with a brain abscess caused by Klebsiella pneumoniae.
Case Report: The neonate, who had been treated with a traditional remedy involving bread dough and spices on the umbilical cord, presented with fever, poor feeding, and lethargy and later experienced seizures. Laboratory investigations confirmed the presence of K. pneumoniae in the blood and cerebrospinal fluid (CSF). Brain magnetic resonance imaging (MRI) demonstrated multiple ring-enhancing lesions in the bilateral frontal and left parietal regions, suggestive of brain abscesses. After treatment, the patient’s condition improved, and he was referred to another equipped center for further treatment.
Discussion: Previous cases were linked to idiopathic or maternal causes, such as urinary tract infections. There was no evidence that the causes of these abscesses were community-acquired. This case, the first reported outside of India, may indicate a community-acquired brain abscess.
Conclusion: This case report highlights the need for awareness and appropriate management of brain abscess caused by K. pneumoniae.
Keywords
Main Subjects
- Bentlin MR, de Souza Rugolo LM. Late-onset sepsis: epidemiology, evaluation, and outcome. Neoreviews. 2010;11(8):e426-35. doi: 10.1542/neo.11-8-e426.
- Hadžimuratović E, Hadžimuratović A, Hadžipašić Multiple brain abscesses caused by Serratia marcescens in preterm newborn. Case Rep Perinat Med. 2018;7(1):20170020. doi: 10.1515/crpm-2017-0020.
- de Oliveira RS, Pinho VF, Madureira JF, Machado HR. Brain abscess in a neonate: an unusual presentation. Childs Nerv Syst. 2007;23(2):139-42. doi: 10.1007/s00381-006-0239-8.
- Brouwer MC, Coutinho JM, van de Beek D. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology. 2014;82(9):806-13. doi: 10.1212/wnl.0000000000000172.
- Wojsyk-Banaszak I, Szczapa J. [Central nervous system infections in neonates caused by multiresistant Klebsiella pneumoniae]. Ginekol Pol. 2000;71(9):975-8. [Polish].
- Sundaram V, Agrawal S, Chacham S, Mukhopadhyay K, Dutta S, Kumar P. Klebsiella pneumoniae brain abscess in neonates: a report of 2 cases. J Child Neurol. 2010;25(3):379-82. doi: 10.1177/0883073809338326.
- Qureshi UA, Wani NA, Charoo BA, Kosar T, Qurieshi MA, Altaf U. Klebsiella brain abscess in a neonate. Arch Dis Child Fetal Neonatal Ed. 2011;96(1):F19. doi: 10.1136/ adc.2010.194993.
- Pant P, Banerjee S, Ganguly S. Klebsiella pneumoniae brain abscess in two neonates. Indian Pediatr. 2008;45(8):693-4.
- Louis D, Balasubramanian K, Sundaram V. Multiple brain abscesses and facial palsy in a neonate. Arch Dis Child Fetal Neonatal Ed. 2013;98(3):F239-40. doi: 10.1136/ fetalneonatal-2012-301702.
- Biswas B, Mondal M, Thapa R, Mallick D, Datta AK. Neonatal brain abscess due to extended-spectrum beta-lactamase producing Klebsiella pneumoniae. J Clin Diagn Res. 2014;8(11):PD01-2. doi: 10.7860/jcdr/2014/10160.5198.
- Basu S, Mukherjee KK, Poddar B, Goraya JS, Chawla K, Parmar VR. An unusual case of neonatal brain abscess following Klebsiella pneumoniae Infection. 2001;29(5):283- 5. doi: 10.1007/s15010-001-1082-1.
- Renier D, Flandin C, Hirsch E, Hirsch JF. Brain abscesses in neonates. A study of 30 cases. J Neurosurg. 1988;69(6):877- 82. doi: 10.3171/jns.1988.69.6.0877.
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