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A 6-year-old boy presented with a pontine abscess initially misdiagnosed as brainstem glioma, but he deteriorated rapidly and developed new symptoms of respiratory distress. Magnetic resonance (MR) imaging revealed a rapidly growing mass lesion in the pons. Microsurgical evacuation of the abscess via a suboccipital retromastoid approach resulted in neurological improvement and resolution of the le sion on MR images. Brainstem abscess can be successfully treated with early, accurate diagnosisdoi:10.2176/nmc.35.160 pmid:7770110 fatcat:s37xfldlgbe73adnalvk6i2hnm