Pediatria pre prax 3/2026

Bacterial infections of the CNS in childhood and surgical treatment options

Bacterial infections of the CNS are potentially life-threatening conditions that demand early diagnosis and treatment. In the pediatric population, they differ from adults in both symptomatology and the spectrum of causative agents. In addition to antibiotic therapy – and especially when disease progression leads to complications – surgical treatment plays an important role. Despite all therapeutic efforts, infectious diseases of the CNS carry a significant risk of long-term consequences in children, owing to the ongoing development of the nervous system at this age. The source of infection is usually hematogenous spread, direct extension from surrounding tissues (per continuitatem), or secondary causes such as trauma or postoperative complications (iatrogenic). The initial manifestation is typically bacterial meningitis, which may progress to subdural or epidural empyema, cerebritis, or brain abscess, as well as infection of the spinal cord itself. Surgical treatment focuses on evacuation of inflammatory foci, resolution of subsequent hydrocephalus, or treatment of brain edema in severe cases. Its indication and implementation are the responsibility of a neurosurgeon and represents a fundamental step in resolving infectious complications.

Keywords: meningitis, abscess, lumbar puncture, tuberculosis, spinal infections, hydrocephalus