What the study found
The study found that pediatric intracranial abscesses and empyemas were managed in varied ways, molecular testing increased pathogen identification, and follow-up imaging often still showed residual findings. The authors also report that one child died and neurologic sequelae occurred in some cases.
Why the authors say this matters
The authors conclude that these infections require intensive multidisciplinary care and that current treatment strategies are markedly heterogeneous. The study suggests that standardized pediatric protocols and prospective studies are needed to improve antimicrobial stewardship, identify children who may safely receive shorter intravenous courses, and harmonize follow-up imaging.
What the researchers tested
The researchers reviewed clinical charts from a single tertiary care pediatric hospital in Italy covering 2017 to 2025. They included children younger than 18 years with brain abscess, subdural empyema, or epidural empyema, and collected clinical, radiologic, microbiologic, immunologic treatment, and outcome data.
What worked and what didn't
Pathogens were identified in 21 of 26 patients, and real-time polymerase chain reaction, a molecular test that detects genetic material from microbes, exclusively detected 43% of isolates. Half of patients received less than 6 weeks of intravenous therapy without recurrence, including 35% of brain abscess cases, while children who underwent drainage or craniotomy had larger lesions and longer intravenous treatment than those managed conservatively. Radiologic follow-up showed residual findings in most cases, and neurologic sequelae occurred in 15% of cases.
What to keep in mind
This was a single-center retrospective study, so the findings come from one hospital's experience. The abstract states that the prognostic significance of residual radiologic structural findings remains unclear, and evidence guiding antimicrobial duration, microbiologic work-up, and radiologic follow-up is limited.
Key points
- The cohort included 26 children with brain abscess, subdural empyema, or epidural empyema.
- Pathogens were identified in 81% of patients, and real-time polymerase chain reaction detected 43% of isolates exclusively.
- Half of the children received less than 6 weeks of intravenous antibiotics without recurrence.
- Drainage or craniotomy was associated with larger lesions and longer intravenous treatment than conservative management.
- Residual findings on follow-up imaging were seen in 60% of cases.
- One child died, and neurologic sequelae were reported in 15% of cases.
Disclosure
- Research title:
- Pediatric intracranial abscesses showed varied treatment and frequent residual imaging findings
- Authors:
- Roberto Privato, Federica Attaianese, Carlotta Montagnani, Agnese Tamborino, Elena Chiappini, Francesco Nieddu, Maria Moriondo, Angelo Galano, Flavio Giordano, Federico Mussa, Giuseppe Indolfi, Sandra Trapani, Luisa Galli, Elisabetta Venturini
- Institutions:
- Istituti di Ricovero e Cura a Carattere Scientifico, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, Meyer Children's Hospital, University of Florence, University of Florence, University of Florence, University of Florence, University of Florence, University of Florence, University of Florence
- Publication date:
- 2026-04-06
- OpenAlex record:
- View
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