Kata Kunci

Abstrak

Introduction: Pediatric cerebral abscesses with an unknown origin of infection occur in approximately 12% of cases. Early diagnosis and treatment are crucial in reducing morbidity and mortality. The incidence of brain abscesses is notably higher in developing countries. The classic triad of fever, headache, and focal neurological signs is observed in only 9–28% of pediatric cases. Brain abscesses, though infrequent, present a potentially life-threatening condition. Case Report: A 1-year and 8-month-old child presented with progressive weakness in the left arm and leg over the past month. The child experienced localized seizures affecting the left arm and leg, with each seizure lasting approximately 30 minutes. Physical examination revealed muscle strength of 3/5 in both upper and lower extremities and hyperreflexia in all limbs. Non-contrast head CT showed a hypodense lesion in the right parietal region with perifocal edema. Contrast-enhanced CT revealed a hypodense lesion in the right parietal lobe with ring enhancement, measuring approximately 6.2 cm x 4.5 cm. The patient underwent craniotomy for abscess evacuation with near-total capsulectomy, followed by capsule resection. Discussion: Advances in neurosurgical techniques, including stereotactic brain biopsy and aspiration, along with improved culture methods and newer generation antibiotics, have significantly enhanced the treatment and outcomes for brain abscesses. Broad-spectrum antibiotics, repeated aspiration, and, in some cases, surgical excision are the current standard treatment modalities. The role of steroids remains controversial; while they may slow the encapsulation process and increase the risk of necrosis, they also potentially reduce antibiotic penetration into brain tissue and cause rebound effects. Medical treatment is generally recommended for patients without increased intracranial pressure, those with symptoms lasting less than one week, and abscesses smaller than 2 cm on imaging. Conclusion: Broad-spectrum antibiotics are the optimal treatment approach in the postoperative management of cerebral abscesses with unknown infection origins.