Brain abscess following meningitis in a neonate: report of three cases

Background: Brain abscess is an infrequent complication of meningitis, including cases caused by Gram-negative enteric bacteria and Klebsiella in neonates. Brain abscess in neonates associated with high morbidity and mortality. Recently, incidence of the disease is increasing because of increased predisposing factors. Patients: Three cases of brain abscess in neonates are reported, 2 of them were caused by Citrobacter meningitis while another case was caused by Klebsiella abscess following meningitis. All of the abscesses were enormous, and multiple abscesses were observed in 1 case. The abscesses were treated by aspiration and antibiotics. Shunt for hydrocephalus was necessary in all patients. No sources of infection were identified in three cases. The onset of infection was not clear in our cases. Finally, 1 patient could improvement while the other two patients were died. One extremely rare case of Klebsiella brain abscesses was reported. Conclusion: All neonates with Citrobacter and Klebsiella meningitis should have neuroimaging studies performed due to the substantial risk of associated brain abscesses, even when suspicious signs are absent. Prompt diagnosis and treatment are essential to reduce the neurological morbidity and the risk of death.