The Diagnostic Challenge of the Pediatric Brain Abscess

Pediatric brain abscess (PBA) is a rare condition that portends a high mortality rate if not recognized and treated early. The spectrum of clinical manifestations of this disease process is wide and can often be vague, making it difficult for timely diagnosis in the emergency department. We detail the presentation of a four-year-old male with autism and a four-day history of decreased activity after a fall with a critical and rapidly worsening clinical course. Subsequent operative intervention revealed a diagnosis of PBA. This case highlights the clinical challenges of diagnosing altered mental status in a developmentally challenged pediatric patient.