Bacterial Infections of the Central Nervous System in Pediatric Intensive Care Unit: A Case Series

Abstract

Bacterial infections of the central nervous system (CNS) are considered serious infections and medical emergencies in children, requiring immediate treatment and diagnosis by clinical diagnosis and laboratory and radiological investigation. Acute bacterial meningitis, subdural empyema, intracerebral abscess, and ventriculitis are the most common central nervous system (CNS) bacterial infections admitted to the pediatric intensive care unit, with a 30% mortality rate and neurological disabilities impacting one-third of survivors. In this case series, we reveal two pediatric patients admitted to the intensive care unit at Benghazi Hospital. The first case is a 10-year-old girl with uncorrected cyanotic congenital cardiac disease, and she presented with a history of fever, headache, and left-side hemiparesis. A computerized tomography scan of the brain (CT) revealed a large brain abscess that was treated with intravenous antibiotics and brain abscess drainage by a neurosurgeon. The second patient, a 9-year-old girl admitted with a history of fever, headache, photophobia, and meningeal signs, had been diagnosed with pyogenic meningitis by cerebrospinal examination (CSF) complicated by epidural empyema. Both patients' signs and symptoms improved significantly, and both were discharged from the hospital with no neurological deficit. The purpose of presenting this case is to emphasize the importance of early diagnosis and treatment of intracranial infections to prevent major consequences resulting in childhood mortality and morbidity. Healthcare professionals have to maintain a high index of suspicion for the diagnosis of such serious infections in children, as well as the importance of a multidisciplinary team in the diagnosis and management of such patients.