By Aria Bendix -
NBC News
After detecting an unusual increase in children with life-threatening brain infections last year, doctors are asking people to pay attention to the symptoms.
Researchers with the Southern Nevada Health District said Thursday that 18 cases of pediatric brain abscesses - pus-filled sacs in the brain - were detected in Clark County in 2022. By comparison, there were an average of five cases a year among 2015 and 2021.
These findings were published at the Centers for Disease Control and Prevention's (CDC) Epidemic Intelligence Service Annual Conference, reported on by CNN.
Pediatric brain abscesses are pus-filled pockets in the brain that can cause death if left untreated.BSIP/Universal Images Group via Getty Images
Dr. Taryn Bragg, an associate professor at the University of Utah who treated the Nevada cases, explained that last spring "every call I got from the ER was from a child who came in with a brain abscess." But the cases in Nevada have decreased. considerably in recent months, he revealed.At the beginning of the year he treated two patients, and since then no more have come through his practice, he said.
Brain abscesses are rare and usually form when fungi or bacteria enter brain tissue from injury or infection.
The body uses healthy tissue to form an abscess to prevent the infection from spreading.
If left untreated, it can cause permanent brain damage or death.
But the causes of the recent increase in brain abscesses in children are unknown.
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When the CDC investigated the trend last year, they identified a national increase in the summer of 2021, followed by a peak in March 2022. However, in their report they also noted that the increase was “consistent with the historical seasonal fluctuations observed since 2016”, and showed that the abscess rate decreased to baseline levels from March to May 2022.
Bragg noted, however, that the CDC's investigation ended as cases in Nevada continued to rise.
Dr. Shaun Rodgers, a pediatric neurosurgeon at Cohen Children's Medical Center, part of Northwell Health in New York, said his hospital is still seeing an above-average number of brain abscesses, a trend that began around the end of 2022.
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“It's not just us.
They are the hospitals of the whole country, ”she stressed.
“When we talk to colleagues, it seems like everyone feels like we've definitely had an uptick in these types of infections,” she said.
Still, he noted that because brain abscesses are rare, this year's total is still in the single digits at his hospital.
Dr. Samir Shah, vice president of Clinical Affairs and Education at Cincinnati Children's Hospital Medical Center, pointed out that brain abscesses occur in about one in eight million people, on average.
However, he added: "We always get worried when we hear people say, 'Hey, we're seeing a little more of this.' We suddenly get on our guard because if something happens, we want to know."
Shah, a co-author of the CDC's national report, suggested that the trend may be due in part to increases in respiratory viruses and bacterial infections -- including group A strep -- during the winter.
Many experts believe that the lack of exposure to viruses and bacteria during the pandemic weakened people's ability to fight them.
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“As soon as we started to undo some of these [pandemic restrictions], the viruses started to come back, there were more sinus infections and, unsurprisingly, more brain abscesses,” Shah says.
Respiratory viruses can cause sinus infections, which can predispose children to brain abscesses, Rodgers explained.
“It looks like we're having an uptick in sinus infections that haven't been diagnosed for a while, and they can go through the bone and into the brain,” she said.
Other researchers have not ruled out the possibility that COVID-19 itself could play a role.
A separate CDC report identified an approximate 100% increase in brain abscesses, on average, at eight pediatric hospitals during the first two years of the pandemic.
One hospital in particular, Helen DeVos Children's Hospital in Grand Rapids, Michigan, saw a 236% increase in bacterial brain infections during that period.
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“We were wondering if the virus itself was causing some kind of inflammatory process that would allow these bacteria to invade,” said Dr. Rosemary Olivero, chief of the hospital's medical subspecialty division.
"That hasn't been a question we've been able to answer yet."
But Olivero said brain abscesses at his hospital are now back to baseline levels and he estimated the hospital has seen fewer than five cases so far this year.
Shah noted that Cincinnati Children's has only had a couple cases of brain abscesses this year.
In general, she added, symptoms to watch for include fever, headache and vomiting.
Children with this condition may also have seizures or stroke-like symptoms, such as impaired motor skills or slurred speech.
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Doctors treat abscesses with antibiotics, and multiple surgeries are often necessary.
According to Shah, a hospital stay of one to two weeks is typical, followed by two to four weeks of additional intravenous antibiotics at home.
Although doctors can voluntarily report cases of brain abscess to public health departments, they are not required to do so.
This makes the national picture unclear, which is why several doctors call for more vigilance.
“I wouldn't be surprised, if you looked at the whole country, if you started to see more of these cases,” Shah says.