Brain Abscess Cases Have Increased Among Children

Intracranial infections — primarily associated with viral and sinus infections — peaked in December 2022, likely due to an uptick in circulating respiratory viruses this past winter.

Brain abscess, or intracranial infection, occurs when an ear or sinus infection migrates to the brain. The infection forms areas of pus in brain tissues causing symptoms including severe headache, fever, nausea, and changes in mental status.

In a CDC Morbidity and Mortality Weekly Report published on June 2, health officials say that the rate of brain abscesses in children has been increasing since 2021, with a significant uptick of cases this past winter.

According to the report, the CDC began investigating a possible rise in cases in May 2022 — mainly caused by Streptococcus bacteria. At the time, data retrieved from children’s hospitals indicated a change in brain abscess patterns after the onset of the COVID-19 pandemic. Still, those changes were within typical ranges, so the CDC continued to watch the situation.

However, after analyzing recent data from 37 hospitals in 19 states and the District of Columbia, the agency says that brain abscess cases have increased from 34 to 61 per month between 2016 and 2019 to 102 cases in December 2022.

Brain abscess rates were lower during the pandemic, likely due to less exposure to respiratory viruses because of social distancing and school closures.

However, cases rose in 2021, then spiked during December 2022. Officials say the increase in circulating respiratory viruses such as RSV and influenza may have contributed to the rise in intracranial infections.

While the number of cases fell from January through March of 2023, they were still above the highest monthly rates observed before the pandemic.

Despite the higher numbers, the CDC says intracranial infections remain rare. In addition, the agency expects to see a lower number of cases as the cold and flu season comes to an end.

Nonetheless, health officials will continue to monitor the situation and recommend that children remain up to date on respiratory disease-related vaccinations.

What are symptoms of a brain abscess in children?

According to Boston Children’s Hospital, brain abscesses are more common in young school-aged children, particularly boys. Symptoms in babies and young children include:

• Fever
• Increased irritability
• A bulging soft spot on the head
• High-pitched crying
• Sleepiness
• Projectile vomiting
• Seizures

In older children, symptoms to watch out for are:

• Severe headache
• Fever
• Nausea or vomiting
• Personality, behavioral, or speech changes
• Difficulty walking or increased arm or leg movement
• Seizures

Treatment for a brain abscess requires hospitalization, medications to control the infection, and sometimes surgery.