title: Successful Treatment with Ultrasound-Guided Aspiration of Intractable Methicillin-Resistant Staphylococcus aureus Brain Abscess in an Extremely Low Birth Weight Infant.
abstract: Brain abscesses are an uncommon and devastating complication of bacteremia in extremely low birth weight infants (<1 kg). We report a 25-week preterm neonate who developed a brain abscess 4 weeks following methicillin-resistant Staphyloccocus aureus (MRSA) sepsis. A huge brain abscess was seen with routine brain sonography on day 19 of life. Despite intravenous vancomycin treatment, the brain abscess increased in size and was associated with increased intracranial pressure on day 49 of life. The brain abscess was accompanied by mild meningeal inflammation with negative blood and cerebrospinal fluid cultures. Diagnosis of abscess was confirmed by bedside ultrasound-guided aspiration, and MRSA was isolated from the pus culture. The MRSA brain abscess refractory to vancomycin was successfully treated by surgical ultrasound-guided percutaneous needle aspiration of brain abscess and prolonged courses of antibiotic administration. At the time of this report, the infant was 9 months old (corrected age was 6 months) and had normal neurodevelopment for her corrected age on the Bayley Infant Neurodevelopmental Screener.
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyun-kyung
authors.initials: HK
authors.lastname: Park
authors.forename: Young-soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Young-soo
authors.initials: YS
authors.lastname: Lee
authors.forename: Sung-hee
authors.initials: SH
authors.lastname: Oh
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D001922:Brain Abscess / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D052577:Infant, Extremely Low Birth Weight; D055624:Methicillin-Resistant Staphylococcus aureus; D019152:Paracentesis / Q000379:methods*; D013203:Staphylococcal Infections / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*