INTRODUCTION We present the largest series of paediatric intracranial empyemas occurring after COVID-19 infection to date, and discuss the potential implications of the pandemic on this neurosurgical pathology. METHODS Patients admitted to our centre between January 2016 and December 2021 with a confirmed radiological diagnosis of intracranial empyema were retrospectively reviewed, excluding non-otorhinological source cases. Patients were grouped according to onset before or after onset of the COVID-19 pandemic and COVID-19 status. A literature review of all post-COVID-19 intracranial empyemas was performed. SPSS v27 was used for statistical analysis. RESULTS Sixteen patients were diagnosed with intracranial empyema: n = 5 prior to 2020 and n = 11 after, resulting in an average annual incidence of 0.3% prior to onset of the pandemic and 1.2% thereafter. Of those diagnosed since the pandemic, 4 (25%) were confirmed to have COVID-19 on recent PCR test. Time from COVID-19 infection until empyema diagnosis ranged from 15 days to 8 weeks. Mean age for post-COVID-19 cases was 8.5 years (range: 7-10 years) compared to 11 years in non-COVID cases (range: 3-14 years). Streptococcus intermedius was grown in all cases of post-COVID-19 empyema, and 3 of 4 (75%) post-COVID-19 cases developed cerebral sinus thromboses, compared to 3 of 12 (25%) non-COVID-19 cases. All cases were discharged home with no residual deficit. CONCLUSION Our post-COVID-19 intracranial empyema series demonstrates a greater proportion of cerebral sinus thromboses than non-COVID-19 cases, potentially reflecting the thrombogenic effects of COVID-19. Incidence of intracranial empyema at our centre has increased since the start of the pandemic, causes of which require further investigation and multicentre collaboration.

中文翻译：

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COVID-19 时代的颅内脓胸：一种新现象？儿科病例系列和文献综述。

引言 我们介绍了迄今为止发生在 COVID-19 感染后最大规模的儿童颅内脓胸系列，并讨论了该流行病对这种神经外科病理学的潜在影响。方法 对 2016 年 1 月至 2021 年 12 月期间入院且放射学确诊为颅内脓胸的患者进行回顾性分析，排除非耳鼻科来源病例。根据 COVID-19 大流行发生之前或之后以及 COVID-19 状态对患者进行分组。对所有 COVID-19 后颅内脓胸进行了文献综述。使用 SPSS v27 进行统计分析。结果 16 名患者被诊断为颅内脓胸：2020 年之前 n = 5 例，2020 年之后 n = 11 例，导致大流行爆发前的年平均发病率为 0.3%，之后为 1.2%。在大流行以来确诊的人中，最近的 PCR 检测证实有 4 人 (25%) 感染了 COVID-19。从感染 COVID-19 到脓胸诊断的时间从 15 天到 8 周不等。COVID-19 后病例的平均年龄为 8.5 岁（范围：7-10 岁），而非 COVID 病例的平均年龄为 11 岁（范围：3-14 岁）。所有 COVID-19 后脓胸病例中均生长有中间链球菌，4 例 COVID-19 后脓胸病例中有 3 例（75%）出现脑窦血栓，而 12 例非 COVID-19 病例中有 3 例（25%）出现脑窦血栓。所有病例均出院回家，没有残留赤字。结论 我们的 COVID-19 后颅内脓胸系列显示，脑窦血栓形成的比例高于非 COVID-19 病例，可能反映了 COVID-19 的血栓形成效应。自疫情发生以来，我中心颅内脓胸发病率有所增加，其原因需要进一步调查和多中心协作。