Background: While intracranial abscesses represent a rare yet serious infectious risk in the pediatric population, those collections limited to the brainstem are even rarer still. We report the clinical presentation and hospital course of a brainstem abscess isolated to the medulla oblongata of a 23-month-old child.
Case/Findings: This abscess initially presented with a non-specific constellation of symptoms including fever, diarrhea, and listlessness, and was diagnosed via magnetic resonance imaging (MRI) only after the patient spent three days in the hospital without showing signs of significant clinical improvement back to baseline. She then underwent incision and drainage by neurosurgery and a prolonged antibiotic course, with eventual complete resolution of the collection more than one month after initial presentation.
Conclusion: This is a case of exceptional rarity, due to the scarcity of documented intracranial abscesses isolated to this region. In addition, this case offers insight into the need to include intracranial infectious pathology on the differential diagnosis of a patient with nonspecific symptoms associated with an altered mental status.
Walter Wiswell, Katie Jerzewski and Melissa McGuire