Clinical presentation and outcome of children with brain abscess: Author's reply

I agree with comments given by reader.We would have definitely improved our observation and knowledge by analyzing the factors (Both clinical and radiological) related to the outcome of brain abscess in our cohort.Since data was not collected in that manner, we did not analyze it.We will incorporate your advice in our future studies.Information regarding type of seizure, antiepileptic drug used, and electroencephalographic abnormalities were not collected; thus, this information cannot be provided.As this cohort was not followed for long, the data regarding the number of patients developing epilepsy was not collected.All our patients were seizure free at discharge and we were able to stop in follow-up next 3 months.Seven patients required the management of raised intracranial tension and four patients had established papilledema.Antibiotic change was required in only five patients based on culture sensitivity report.Proteus mirabilis (n-2) was sensitive to amoxicillin-clavulanic acid, gentamicin, amikacin, and piperacillin-tazobactam, ceftazidime, and resistant to ampicillin, ceftriaxone, cefotaxime, and fluoroquinolones.We have not analyzed our outcome based on culture sensitivity report as there were only five cases in culture-positive group and this may have yielded spurious results.Factors like chronic paranasal sinusitis, orbital cellulitis, dental infection, history of penetrating head injury, presence of malignancy, or use of immunosuppressants were not present in this cohort.We could not do a full set of investigations for immunodeficiency except immunoglobulin profile due to lack of funding.We have mentioned this in our limitation to the study.Levels of immunoglobulin (IgA, IgG, IgM, and IgE) were in normal range for age and sex.Open craniotomy followed by aspiration was done in six cases.Indications in our cohort were failure of burr hole aspiration in five cases and fungal abscess in one case.

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