The face of pediatric and adult brain abscesses, differences and clinical characteristics: a single center 10-year experience.

BACKGROUND: Brain abscesses (BA) are a medical emergency in all age groups and require early diagnosis and treatment. Childhood BA constitute 25% of all abscesses and may have a different clinical course than adults. This article aims to investigate patients followed up for adult and child BA over a 10-year period. MATERIALS AND METHODS: A retrospective analysis was performed on adult and pediatric patients diagnosed with BA. Demographic, clinical, predisposing factors, imaging, treatment modalities, and prognosis of the patients, and clinical differences were examined. RESULTS: Of a total of 46 patients; 54.3% of the patients were children and the mean age was 10.9±6.3 years for the pediatric group and 46.2±16.7 years for the adult group. Fever, vomiting, and seizures were significantly higher in children (p<0.05). When the differences between the groups were examined, headache was the most common finding in the adult group, while the most common finding in children was fever and vomiting. The classic triad of fever, headache, and focal neurological deficits was present in 12 (48%) of the children, compared to only 4 (19.1%) of the adults. Trauma history (21.7%), immunosuppression (19.5%), and local spread (mastoiditis, sinusitis, and otitis) (32.6%) were among the most common predisposing factors. Previous otorhinolaryngogenic infections were the most common cause in children (36%), while immunosuppression was the most common cause in adults (28.5%). The frontal lobe was most frequently involved among the patients (47.8%). BA was more commonly localized in the left hemisphere in both groups. Culture growth was detected in 23.9% of all operated patients, with a positivity rate of 20% in children and 28% in adults. The most common microorganism was Staphylococcus aureus (8.6%). The average hospitalization time was significantly longer in children than in adults (46 ± 18 days vs 34 ± 13 days; p=0.024). 26.1% of the patients recovered with sequelae, and the mortality rate was 8.6%. CONCLUSION: Our findings suggest that a high index of suspicion should be maintained for BA in children, especially in the presence of fever, vomiting, and seizures. This study highlights significant clinical and etiological differences between pediatric and adult BA, underscoring the importance of age-specific diagnostic and management strategies. The differences observed in clinical presentation and underlying causes between the two groups warrant further investigation to improve outcomes.