Brain Abscesses in Paediatric Patients at Kenyatta National Hospital: Pattern of Presentation, Treatment and Short-term Outcomes

Abstract

1.1 Background Paediatric brain abscesses are a concern as they carry significant morbidity and mortality. There is no international consensus on a singular optimal approach to brain abscesses and their management varies between institutions. 1.2 Study objective This study aimed at describing the pattern of clinical presentation, management and short term outcome of brain abscesses in children at the Kenyatta National Hospital. 1.3 Methodology: 1.3.1 Study design and site This was a prospective cross sectional non-interventional study conducted at KNH from January 2023 to May 2024. 1.3.2 Study population Patients under 17 years of age who satisfied the inclusion criteria were included in the study. 1.4 Results 25 patients were studied. The mean age was 8.73 years (SD=5.81). There was a slight male predominance (52%). Convulsions (20%) was the most common clinical presentation. There was a high rate of sterile cultures (77.8%) with Gram-positive cocci and Gram-negative bacilli as main pathogens necessitating broad-spectrum antibiotics most often comprising of Ceftriaxone, metronidazole and vancomycin. Phenytoin was the AED used most often to treat convulsions (41.67%). Radiologically, abscesses favoured the frontal (44%) and parietal lobes (28%). Surgery, especially craniotomy for drainage (85%) was the primary definitive management. Favourable GOS-E was achieved in 75% of patients. 1.5 Conclusions Limited sample size underscores the need for larger prospective studies with longer follow up duration to validate findings. Early recognition, timely intervention, and individualized care are crucial. Further research into improved diagnostic and treatment strategies, especially in resource-limited settings is needed to…