Before March of last year, Nevada’s only pediatric neurosurgeon treated, on average, one or two brain abscesses in children every year.
Then, seemingly out of nowhere, "I was seeing case after case."
"Every kid that came into the ER was coming in with a brain abscess and needing emergent surgery," Dr. Taryn Bragg said in an interview with FOX TV Stations.
It turns out, Bragg wasn’t the only doctor experiencing the surge. The U.S. Centers for Disease Control and Prevention began investigating in May 2022 after three children in California were hospitalized with brain abscesses. Bragg said other neurosurgeons she spoke to in the Southwest were seeing the same upward trend.
Before 2022, Clark County, Nevada, averaged about five cases per year. Last year, there were 17, and most of them were seriously ill.
"The vast majority of children required at least one surgical intervention," Bragg recalled. "Most of them required three to four interventions, and some required up to six to completely eradicate the infection and treat the brain swelling associated with it."
What caused the spike?
After Bragg sounded the alarm, the Southern Nevada Health District coordinated a data analysis to see if epidemiologists could find a direct link to the cases, but there were no common exposures found.
Child brain scans (Getty Images)
A report published by the CDC in September acknowledged an uptick in pediatric brain abscesses in multiple states, but their report found that seasonal spikes in cases have been reported in years past.
The majority of children Bragg treated were infected with Streptococcus intermedius, a bacterium that doesn’t typically cause health problems, but when it does, brain abscess is a common complication, she said.
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Bragg said she notified the health district because she wanted to make sure area pediatricians were aware of such a significant spike. She also hoped treating pediatric sinus infections with antibiotics early on would lower the risk of it spreading to the brain.
Another factor that surprised Bragg was the ages of the children she treated: The youngest one was 5 years old.
"What’s surprising about that is the frontal sinus, the aerated portion of the frontal bone, typically doesn’t develop until children are 8 or 9 years old," Bragg explained. "So often it’s very uncommon to see a sinus infection in a child younger than that become a brain abscess because the aerated bone is very thin, but we were still seeing kids of young ages without aerated sinuses developing these infections."
Although no direct causations have been identified, Bragg said "they may just be catching up on other illnesses we’ve seen spikes in following the pandemic, such as the decline in viral infections that are presenting again."
"But it was just really unusual to see this. It’s really unprecedented," she said.
Should parents be concerned?
Fortunately, infection rates have slowed since last year, Bragg said. She’s treated two additional children for abscesses since the study was done, and those cases weren’t as severe.
"I don’t want families being overly concerned that their children are likely to have this happen," Bragg said. "It’s still very rare, and the numbers are trending down."
An abscess, or a pus-filled pocket in the brain, will typically cause much more serious symptoms than a common sinus infection, Bragg said.
"Many of the children presented quite ill in 2022, seizures, altered mental status, weakness, significant deficits that remarkably have recovered," Bragg said. "It’s very different than your common cold."
According to Boston Children’s Hospital, brain abscess symptoms in children include:
- complaints of severe headaches
- nausea and vomiting
- changes in personality or behavior
- changes in speech
- problems walking
- increased movement in the arms or legs (spasticity)
Bragg said the CDC and public health agencies are continuing to monitor case counts.