Cyanotic complex congenital heart disease presenting with brain abscess at the age of 19: A case report and review of literature

Sabah, Khandker Md Nurus; Chowdhury, Abdul Wadud; Islam, Mohammad Shahidul; Ahmed, Mohsin; Amin, Gaffar; Islam, Kazi Nazrul; Kawser, Shamima; Khan, HI Lutfur Rahman; Saleh, Mohammed; Khan, Zayed Mahbub

doi:10.3329/bhj.v31i1.30621

Cited by 3 publications

(4 citation statements)

References 8 publications

(11 reference statements)

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“…The case of a 3-year-old male with Tetralogy of Fallot (TOF) who presented with multiple parietooccipital brain abscesses represents a remarkable medical challenge, emphasizing the critical significance of early detection and intervention in the context of this uncommon clinical scenario. TOF itself is a complex congenital heart condition characterized by four structural defects within the heart [ 1 ]. However, when coupled with the development of multiple brain abscesses, the situation becomes notably intricate [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Tetralogy of Fallot complicated by multiple cerebral abscesses in a child: a case report

Kamabu,

Sikakulya,

Kataka

et al. 2024

J Med Case Reports

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Introduction Brain abscesses are rare but potentially fatal condition and can be associated with cyanotic congenital heart disease of which 5–18.7% of these patients that develop cerebral abscess commonly have tetralogy of Fallot (TOF). Case presentation We report a case of 3-year-old Muganda male that presented with convulsions, cyanosis and difficulty in breathing. The patient had a combination intervention of medical treatment and surgical drainage of the abscess. Post-operative Computerized tomography scan images and pre-operative brain Computerized tomography scans were compared. The multiple rings enhancing lesions were reduced in number and sizes. The largest measured ring was 44 × 22.5×16mm compared to the previous; 42 × 41×36mm. The mass effect had reduced from 16 mm to 7.5 mm. The periventricular hypodensities persisted. Findings showed radiological improvement with residual abscesses, subacute subdural hematoma and pneumocranium. The patient was treated with intravenous ceftriaxone 1 g OD for six weeks and he showed marked improvement and was discharged home after 3 months. Conclusion A comprehensive strategy involving medications, surgical drainage, and early neurosurgical consultation is vital in treating brain abscesses in uncorrected TOF. Early identification of the pathogen, appropriate antibiotic therapy, and vigilant follow-up through clinical assessments and imaging are crucial, potentially spanning a 4–8-week treatment.

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Section: Discussionmentioning

confidence: 99%

Tetralogy of Fallot complicated by multiple cerebral abscesses in a child: a case report

Kamabu,

Sikakulya,

Kataka

et al. 2024

J Med Case Reports

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“…Dehydration and iron deficiency can trigger symptoms of hyperviscosity (Rose et al, 2007). The incidence of polycythemia in cyanotic CHD will induce the occurrence of small infarcts in blood vessels which causes bacteria or microorganisms to easily penetrate the blood-brain barrier (Parra et al, 2018;Sabah et al, 2016;Takeshita et al, 1992).…”

Section: Hemoglobinmentioning

confidence: 99%

Risk factors for mortality in children with cyanotic congenital heart disease associated with brain abscess

Pratiwi

Gunawan

Rahman

et al. 2022

ijhs

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Brain abscess is a local infection within the brain parenchyma. Predisposing factors include cyanotic congenital heart disease (CHD). Identification of risk factors for mortality is important to determine the prognosis. A case-control study of children with cyanotic CHD associated with brain abscess was conducted in the pediatric ward of a hospital from January 2016 to December 2020. Data were collected from medical records with the case to controls ratio of 1:3.07. A total of 61 children were evaluated, 46 children survived and 15 children non-survived. From 11 risk factors evaluated, 6 risk factors had a significant different of mortality risk included the level of hemoglobin (p=0.07), leukocyte (p=0.063), Neutrophil-to-lymphocyte ratio (NLR) (p<0.001), peripheral oxygen saturation (SpO2) (p=0.00), multiple abscesses (p=0.008), brain abscess diameter (p<0.001). Multivariate logistic regression analyses revealed significant risk factors for mortality in cyanotic CHD children with brain abscesses were NLR (OR 13.62, 95%CI 2.123-87.319, p=0.006); SpO2 (OR 1.5, 95% CI 1.25-2, p=0.04); brain abscess diameter (OR 7.61, 95%CI 1.064-54.434, p=0.043). NLR, brain abscess diameter, and SpO2 were the risk factors in increasing mortality in cyanotic CHD children with brain abscess. The prevention of abscess cerebral development and cyanotic CHD management are needed to reduce the mortality.

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“…2,7 Pasien lebih banyak berjenis kelamin laki-laki dengan perbandingan 2:1, penelitian sebelumnya menunjukkan bahwa jenis kelamin laki-laki lebih dominan 1,5 sampai 2,5 kali dibandingkan perempuan. 8 Pada penelitian ini didapatkan sebagian besar pasien dengan status nutrisi gizi kurang, diikuti malnutrisi, tidak ada status nutrisi gizi baik atau gizi lebih pada pasien PJB sianotik dengan abses serebri.…”

Section: Pembahasanunclassified

“…Deteksi dini, fasilitas radiologi yang memadai, dan terapi antibiotik berperan dalam prognosis yang lebih baik. 8…”

Section: Pembahasanunclassified

Kejadian Abses Serebri Pada Pasien PJB Sianotik Di Rs DR M Djamil Padang

Trisiana

2021

Human Care

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Abstract Objective : Cyanotic CHD is a congenital disease, insidence tend to increased with time. At M Djamil Hospital there was 85 case in 2013-2015. Brain abscess is the complication that mostly found in patient that can be serious and fatal. The aim of this study is to identify characteristics and factors in the occurence of brain abscess in cyanotic CHD patients. Methods : This was a cross sectional study. Data were collected from medical records of cyanotic CHD patient who admitted at M Djamil Hospital from 2016 to 2018. Bivariate analysis using paired sample T test and chi square. Data were analyzed with SPSS. P value <0.05 were considered to be statistically significant. Result : A total 15 patient (14.5%) brain abscess of 104 cyanotic CHD were found. Majority patient were boys (67.3%). The subjects mean age was 4.95 years and the youngest age was 1 year old. Nutritional status (p=0.009), head circumference (p=0.005), cyanotic spell (p=0.028), blood gas analysis (p=0.005), and outcome (p=0.005) were significant related factors for brain abscess. Hemoglobin (16.65±3.57), leucocyte (18775±7749.28), hematocryte (54.87±7.90), oxygen saturation (59.93±9.21) were statistycally significant. The culture of abscess were no growth. 9 of 15 patient with brain abscess were died. Conclusion : poor nutritional status, microcephaly, cyanotic spell, metabolic asidosis, hemoglobine, leucocytosis, high hematocryte, and low peripheral oxygen saturation were the significant related factors to brain abscess in cyanotic CHD patients. No bacterial growth in abscess culture. Mortality was still high, sixty percent of brain abscess child were died.Keywords: Brain abscess; cyanotic; congenital heart disease. AbstrakTujuan : insiden pasien penyakit jantung bawaan siantoik semakin bertambah. Di RS Dr. M. Djamil Padang terdapat sebanyak 85 kasus selama tahun 2013-2015. Abses serebri merupakan komplikasi yang paling sering ditemukan dan dapat berakibat serius. Penelitian ini bertujuan mengidentifikasi karakteristik dan faktor yang berhubungan dengan kejadian abses serebri pada pasien PJB sianotik. Metode : suatu penelitian cross sectional, dengan pengumpulan data dari rekam medis pasien PJB sianotik di RS Dr. M. Djamil tahun 2016-2018. Analisis bivariate dengan uji T dan chi square. Kemaknaan signifikan pada p value <0.05. Hasil : total sejumlah 104 pasien PJB sianotik, 15 pasien (14,5%) mengalami abses serebri. Jenis kelamin laki-laki 67,3%. Rerata usia 4.95 tahun dan termuda usia 1 tahun. Faktor yang berhubungan signifikan yaitu status gizi (p=0.009), lingkar kepala (p=0.005), cyanotic spell (p=0.028), analisa gas darah (p=0.005) dan outcome (p=0.05). Hubungan signifikan kejadian abses serebri dengan kadar hemoglobin (16.65±3.57), leukosit (18775±7749.28), hematokrit (54.87±7.90), dan saturasi oksigen (59.93±9.21). Pada pemeriksaan kultur abses tidak ditemukan pertumbuhan mikroorganisme. Sebanyak 9 dari 15 pasien meninggal. Kesimpulan : status gizi buruk, mikrosefal, cyanotic spell, asidosis metabolic, kadar hemoglobin, leukosit, hemokonsentrasi, dan saturasi oksigen perifer rendah merupakan faktor-faktor yang berhubungan signifikan dengan kejadian abses serebri pada pasien PJB sianotik. Tidak ada pertumbuhan mikroorganisme pada kultur cairan abses. Mortalitas cukup tinggi, sebanyak 60% pasien meninggal. Kata kunci : abses serebri; penyakit jantung bawaan; sianotik

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Cyanotic complex congenital heart disease presenting with brain abscess at the age of 19: A case report and review of literature

Cited by 3 publications

References 8 publications

Tetralogy of Fallot complicated by multiple cerebral abscesses in a child: a case report

Tetralogy of Fallot complicated by multiple cerebral abscesses in a child: a case report

Risk factors for mortality in children with cyanotic congenital heart disease associated with brain abscess

Kejadian Abses Serebri Pada Pasien PJB Sianotik Di Rs DR M Djamil Padang

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