In October 2022, the Southern Nevada Health
District (SNHD) received reports of higher-than-expected
pediatric patients in Clark County with intracranial abscess
in 2022. This followed a CDC-led national investigation into
this topic, which concluded in May 2022. SNHD investigated
to confirm if this was above expected, identify common risk
factors for infection, and report findings to the community.
Methods: Hospital discharge data were used to identify 2022
cases and evaluate trends during 2015–2021. Cases were
diagnosis of intraparenchymal abscess, subdural abscess
or empyema, epidural abscess or empyema, or evidence of
intracranial extension on imaging in a patient aged ≤18 years
without a previous neurosurgical procedure or head trauma.
For cases that occurred during January 1, 2022–December
31, 2022, hospital course and microbiologic findings were
assessed through data abstraction, and telephone interviews
were conducted using a semistructured survey with parents or
guardians.
Results: During 2015–2021, the annual median incidence of
intracranial abscess was 4 cases/year in Clark County. During
the COVID-19 pandemic (2020–2021), the median incidence
was 7 cases/year. In 2022, 18 cases were identified with no
associated deaths. Median age was 12 years, and most were male
(n = 14; 78%). Fifteen patients (83%) required craniotomy. The
most common bacterial pathogen isolated was Streptococcus
intermedius (n = 6; 33%). Among 14 (78%) parents or guardians
interviewed, 9 (64%) caregivers reported their child had cold
symptoms, but none reported a COVID-19 diagnosis. Three
(21%) reported their child was diagnosed with otitis media and
1 (7%) with sinus infection. Eleven (79%) children had sought
care before hospitalization.
Conclusions: The number of pediatric intracranial abscesses in
Clark County, Nevada, was higher in 2022 than previous years.
More research is needed to identify specific risk factors and
causes of this rare condition, and surveillance should continue
to understand future trends.