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Parameningeal Infections

Fever, Headache, and An Abnormal Neurologic Examination

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Introduction to Clinical Infectious Diseases
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Abstract

Parameningeal infections are relatively uncommon. Focal intracranial infections are divided into three main categories based on their anatomic location: brain abscess, spinal epidural abscess, and subdural empyema. All three of these focal infections arise either from either direct spread from contiguous infections such as sinusitis, otitis media, or cranial osteomyelitis, hematogenous seeding during bacteremia or as a result of a penetrating injury. The clinical manifestations of parameningeal infections vary based on the site of infection. Symptoms and signs of brain abscess and subdural empyema include fever, headache, vomiting, seizures, and altered mental status. Spinal epidural abscesses present with fever, back pain, and focal neurological deficits. The diagnostic evaluation of parameningeal infections requires advanced imaging technology. Magnetic resonance imaging is preferred in most instances. Management of these infections requires a multidisciplinary approach, consisting of a combination of neurosurgical intervention and appropriate long-term antibiotic therapy. Depending on the clinical circumstances, search for an underlying source for the parameningeal infection may need to be pursued.

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References

  1. Mathisen G, Johnson P. Brain abscess. Clin Infect Dis. 1997;25:763–81.

    Article  CAS  Google Scholar 

  2. Muzundar D, Jhawar G. Brain abscess: an overview. Int J Surg. 2011;9:136–44.

    Article  Google Scholar 

  3. Bonfield C, Sharma J, Dobson S. Pediatric intracranial abscesses. J Infect. 2015;71(Suppl):42–S46.

    Article  Google Scholar 

  4. Tonon E, Scotton P, Gallucci M, et al. Brain abscess; clinical aspects of 100 patients. Int J Infect Dis. 2006;10:103–9.

    Article  Google Scholar 

  5. Goodkin H, Harper M, Pomeroy S. Intercerebral abscess in children: historical trends at Children’s Hospital Boston. Pediatrics. 2004;113:1765–9.

    Article  Google Scholar 

  6. Foerster B, Thurnher M, Malani N, et al. Intracranial infections: clinical and imaging characteristics. Acta Radiol. 2007;8:875–93.

    Article  Google Scholar 

  7. Nickerson J, Richner B, Santy K, et al. Neuroimaging of pediatric intracranial infection – part 1: techniques and bacterial infections. J Neuroimaging. 2012;22:e42–51.

    Article  Google Scholar 

  8. Sheehan J, John J, Dibyendu R, et al. Brain abscess in children. Neurosurg Focus. 2008;24E6:1–5.

    Google Scholar 

  9. Cole T, Clark M, Jenkins A. Pediatric focal intracranial suppuration: a UK single- center experience. Childs Nerv Syst. 2012;28:2109–14.

    Article  Google Scholar 

  10. Moorthy R, Rajshekhar V. Management of brain abscess; an overview. Neurosurg Focus. 2008;24E3:1–5.

    Google Scholar 

  11. Reihsaus E, Waldbaur H, Seeling W. Spinal epidural abscess: a meta-analysis of 915 patients. Neurosurg Rev. 2000;232:325–204.

    Google Scholar 

  12. Darouiche R. Spinal epidural abscess. N Engl J Med. 2006;355:2012–20.

    Article  CAS  Google Scholar 

  13. Martino A, Winfield J. Salmonella osteomyelitis with epidural abscess. A case report with review of osteomyelitis in children with sickle cell anemia. Pediatr Neurosurg. 1990;16:321–5.

    Article  Google Scholar 

  14. Auletta J, Chandy J. Spinal epidural abscess in children: a 15-year experience and review of the literature. Clin Infect Dis. 2001;32:9–16.

    Article  CAS  Google Scholar 

  15. Heuser A. Nontuberculous spinal epidural infections. N Engl J Med. 1948;239:845–54.

    Article  Google Scholar 

  16. Hawkins M, Bolton M. Spinal epidural abscess in children: a 15 year experience and review of the literature. Pediatrics. 2013;132e:1680–5.

    Article  Google Scholar 

  17. Barone S, Aiuto L, Black K, et al. Staphylococcal meningitis secondary to sacral osteomyelitis in and infant. Clin Pediatr. 1997;36:301–4.

    Article  CAS  Google Scholar 

  18. Patel A, Alton T, Bransford R, et al. Spinal epidural abscesses: risk factors, medical vs surgical management, a retrospective review of 128 cases. Spine J. 2014;14:326–30.

    Article  Google Scholar 

  19. Legrand L, Roujeau T. Paediatric intracranial empyema: differences according to age. Eur J Pediatr. 2009;168:1235–41.

    Article  Google Scholar 

  20. Sandler A, Thompson D, Goodrich J, et al. Infections of the spinal subdural space in children: a series of 11 contemporary cases and review of all published reports. A multinational collaborative effort. Childs Nerv Syst. 2013;29:105–17.

    Article  Google Scholar 

  21. Bockova J, Rigamonti D. Intracranial empyema. Pediatr Infect Dis J. 2000;19:735–7.

    Article  CAS  Google Scholar 

  22. Smith H, Hendrick B. Subdural empyema and epidural abscess in children. J Neurosurg. 1983;58:392–7.

    Article  CAS  Google Scholar 

  23. Hendaus M. Subdural empyema in children. Glob J Health Sci. 2013;5:54–9.

    Article  Google Scholar 

  24. Hicks C, Weber J, Reid J, et al. Identifying and managing intracranial complications of sinusitis in children. Pediatr Infect Dis J. 2011;30:222–6.

    Article  Google Scholar 

  25. Komgogiorgas D, Seth R, Athwal P, et al. Suppurative intracranial complications of sinusitis, other than meningitis in adolescence, single institute experience and review of literature. Br J Neurosurg. 2007;21:603–9.

    Article  Google Scholar 

  26. Patel N, Garber D, Hu S, et al. Systematic review and case report: intracranial complications of pediatric sinusitis. Int J Pediatr Otorhinolaryngol. 2016;86:200–12.

    Article  Google Scholar 

  27. Wackym P, Canalis R, Feuerman T. Subdural empyema of otorhinological origin. J Laryngol Otol. 1990;104:118–22.

    Article  CAS  Google Scholar 

  28. Yogev R. Suppurative intracranial complications of upper respiratory infections. Pediatr Infect Dis J. 1987;1987:324–7.

    Article  Google Scholar 

  29. Patel N, Masterson L, Deutsch J, et al. Management and outcomes in children with sinogenic intracranial abscesses. Int J Pediatr Otorhinolaryngol. 2015;79:868–73.

    Article  Google Scholar 

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Correspondence to Stephen Barone .

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Barone, S. (2019). Parameningeal Infections. In: Domachowske, J. (eds) Introduction to Clinical Infectious Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-91080-2_24

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  • DOI: https://doi.org/10.1007/978-3-319-91080-2_24

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