Objective: To report a Central Nervous System infection evolving with brain abscess and to address aspects of the treatment of the disease. Results: even with advances in treatment and diagnosis, the pathology has a high mortality. However, the best prognosis is noticed when there is a suspicion through the clinic, neuroradiological images readily available, antimicrobial therapy against commonly encountered agents, and surgical drainage procedures. One study, which combined antibiotic therapy and surgery to drain the abscess, in most of the cases, studied, demonstrated a mortality rate of 12%, and another study, a 42% mortality rate when using antibiotic therapy alone. Another reference suggests the use of antibiotic therapy alone in less severe cases with less neurological impairment. Neurological clinical sequelae can be found in up to 30% of cases. The time of antibiotic therapy still needs to be debated, as well as the surgical indication for drainage. Final Considerations: Pediatric brain abscess is an uncommon disease, still with high morbidity and mortality. Surgical drainage or excision of pediatric abscesses remains the basis of treatment both to relieve the mass effect and to provide a microbiological diagnosis. The literature demonstrates that broad-spectrum antibiotics and access to CT and MRI images decrease the rates of morbidity and mortality. It is concluded that the therapeutic approach involves the administration of broad-spectrum intravenous antibiotics and surgical drainage in more complex cases.
Objective: Report of a case of Multisystem Inflammatory Syndrome in Children (MIS-C) post-COVID 19 and review of articles on the topic. Results: Coronavirus 2 (SARS-CoV-2) infection is a disease whose symptoms are similar between the adult and pediatric population, ranging from asymptomatic cases to more serious conditions that have spread global terror due to the high number of infections worldwide deaths. However, children have presented a milder clinic. It is worth mentioning, however, that this population is not completely risk-free, with reports of the association of the Coronavirus triggering inflammatory diseases, such as the so-called MIS-C whose complications can be as serious as the forms of symptoms experienced by adults. Conclusion: The temporal and serological relationship of a link with SARS-CoV-2 infection is supported by consistent data, however further studies are needed to establish SARS-CoV-2 as an inciting agent. Due to the severity of MIS-C, knowledge about this disease is necessary for a quick diagnosis and early treatment, aiming to reduce systemic lesions. Due to the increase in the number of cases of children affected by MIS-C, the use of immunomodulatory drugs, such as intravenous immunoglobulin (IVIG), aspirin, and systemic glucocorticoids, has been instituted as first-line therapy, to reduce inflammation and late complications.
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