Brain Abscess in Undiagnosed Tetralogy of Fallot

Kelvin Nemayire; Kantenga Dieu Merci Kabulo; Luxwell Jokonya; Patrice Ntenga; Aaron Masiiwe Musara; Kazadi Kaluile Ntenga Kalangu

doi:doi:10.11648/j.iji.20180601.11

Brain Abscess in Undiagnosed Tetralogy of Fallot

Kelvin Nemayire, Kantenga Dieu Merci Kabulo, Luxwell Jokonya, Patrice Ntenga, Aaron Masiiwe Musara, Kazadi Kaluile Ntenga Kalangu

Published in International Journal of Immunology (Volume 6, Issue 1)

Received: 5 September 2017 Accepted: 3 January 2018 Published: 19 January 2018

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Abstract

Cardiovascular disease is a leading cause of mortality in all ages worldwide. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) accounting for 10%. There have been several reports of neurological complications associated with TOF. Although it is known, brain abscess (BA) is a serious complication in patients with uncorrected CHD mostly in the age of 4-7 years-old. We report a case of a 7 year old male who presented with a 3 month history of left sided body weakness and a 3 week history of a headache and fever. Patient was chronically unwell since birth where he would experience occasional episodes of exertional dyspnoea which was never investigated. Chest xray showed a globular-shaped heart. CT scan brain showed a 1,8 x 1,3 x 1,5 cm ring-enhancing lesion in the right parietal region with minimal perilesional vasogenic edema communicating with the body of the lateral ventricle, with enhancement of the ependymal lining of the ventricle; echocardiography revealed ventricular septal defect (VSD), overriding of aorta, obstruction to right ventricular outflow tract and hypertrophy of right ventricle consistent with a diagnosis of TOF. We elected to manage the patient conservatively on intravenous antibiotics, Patient improved significantly neurologically and was transferred to the cardiothoracic surgeons for further management of TOF.

Published in	International Journal of Immunology (Volume 6, Issue 1)
DOI	10.11648/j.iji.20180601.11
Page(s)	1-4
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Brain Abscess, Tetralogy of Fallot, Cyanotic Congestive Heart Disease, Exertional Dyspnoea

References

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[2]	Santulli G (2013) Epidemiology of Cardiovascular Disease in the 21st Century: Updated Numbers and Updated Facts. JCvD 1: 1-2.
[3]	Sethi S, Kapil S (2014) Scalp block for brain abscess drainage in a patient with uncorrected tetralogy of Fallot. WJCC 2: 934-937.
[4]	Manuel V, Matias E, Morais H, Miguel G, Nunes MA, de Oliveira A, Manresa J, Junior AP. Brain Abscess in Uncorrected Tetralogy of Fallot Diagnosed during Preparation for Computed Cardiac Angiotomography. J Cardiovasc Dis Diagn. 2015; 3: 193. doi: 10.4172 / 2329-9517.1000193.
[5]	Sidharth Sraban Routray, Khageswar Raut, Debasis Mishra and Rajib Mishra, Cerebral Abscess in a 8 years old with uncorrected tetralogy of Fallot: Anaesthetic challenge, ISSN: 2229-3809 (Online) Journal DOI:10.7439/ijbar, IJBAR (2013) 04 (11).
[6]	Ghafoor T, Amin MU. Multiple brain abscesses in a child with congenital cyanotic heart disease. J Pak Med Assoc. 2006; 56: 603-5.].
[7]	Bernardini GL: Diagnosis and management of brain abscess and Subdural empyema. Curr Neurol Neurosci Rep 4: 448–456, 2004.
[8]	ranjith k. moorthy, m. ch., and vedantam rajshekhar, m. ch., Management of brain abscess: an overview, Neurosurg Focus 24 (6): E3, 2008.
[9]	(Bermstein D. Congenital heart disease. In: Kleigman MR, Behrman ER, Janson BH, Stanton FB. Nelson textbook of pediatrics. 18th ed. New Delhi: Elsevier; 2008. p. 1906-11.
[10]	Sadiq A, Shymkrishnan GK, Theodore S, Gopalkarishnan S, Tharakan MJ, Karunkaran J. Long term functional assessment after correction of tetralogy of fallot in adulthood. Ann Thorac Surg 2007; 83: 1790-5.).
[11]	Sommayya aftab, amir usman, tipu sultan, frequency of cerebrovascular accidents and brain abscess in childrens with tetralogy of fallot, pakistan journal of neurological sciences, vol. 10 (2) apr - jun 2015.
[12]	Ghafoor T, Amin MU. Multiple brain abscesses in a child with congenital cyanotic heart disease. J Pak Med Assoc. 2006; 56: 603–5. [PubMed] 2. Prusty GK. Brain abscesses in cyanotic heart disease. Indian J Pediatr. 1993; 60: 43–51. [PubMed].
[13]	Abhijeet Raha, Pragati Ganjoo, Amay Singh, Monica S. Tandon, and Daljit Singh, Surgery for brain abscess in children with cyanotic heart disease: An anesthetic challenge, J Pediatr Neurosci. 2012 Jan-Apr; 7 (1): 23–26.
[14]	Lumbiganon P, Chaikitpinyo A (2013) Antibiotics for brain abscesses in people with cyanotic congenital heart disease. Cochrane Database Syst Rev 3: 1-13.
[15]	Sani MU, Mukhtar-Yola M, Karaye KM (2007) Spectrum of congenital heart disease in a tropical environment: an echocardiography study. J Natl Med Assoc 99: 665–669.
[16]	Sethi S, Kapil S (2014) Scalp block for brain abscess drainage in a patient with uncorrected tetralogy of Fallot. WJCC 2: 934-937.
[17]	Sethi S, Kapil S. Scalp block for brain abscess drainage in a patient with uncorrected tetralogy of Fallot. World J Clin Cases2014; 2 (12): 934-937.
[18]	Webb GD, Smallhorn JF, Therrien J, Redington AN. Congenital heart disease. In: Zipes DP, Libby P, Bonow RO, Braunwald E, editors. Braunwald’s heart disease: a textbook of cardiovascular medicine. 7th ed. Philadelphia: W. B. Saunders, 2005: 1489-1552.
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APA Style

Kelvin Nemayire, Kantenga Dieu Merci Kabulo, Luxwell Jokonya, Patrice Ntenga, Aaron Masiiwe Musara, et al. (2018). Brain Abscess in Undiagnosed Tetralogy of Fallot. International Journal of Immunology, 6(1), 1-4. https://doi.org/10.11648/j.iji.20180601.11

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ACS Style

Kelvin Nemayire; Kantenga Dieu Merci Kabulo; Luxwell Jokonya; Patrice Ntenga; Aaron Masiiwe Musara, et al. Brain Abscess in Undiagnosed Tetralogy of Fallot. Int. J. Immunol. 2018, 6(1), 1-4. doi: 10.11648/j.iji.20180601.11

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AMA Style

Kelvin Nemayire, Kantenga Dieu Merci Kabulo, Luxwell Jokonya, Patrice Ntenga, Aaron Masiiwe Musara, et al. Brain Abscess in Undiagnosed Tetralogy of Fallot. Int J Immunol. 2018;6(1):1-4. doi: 10.11648/j.iji.20180601.11

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@article{10.11648/j.iji.20180601.11,
  author = {Kelvin Nemayire and Kantenga Dieu Merci Kabulo and Luxwell Jokonya and Patrice Ntenga and Aaron Masiiwe Musara and Kazadi Kaluile Ntenga Kalangu},
  title = {Brain Abscess in Undiagnosed Tetralogy of Fallot},
  journal = {International Journal of Immunology},
  volume = {6},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.iji.20180601.11},
  url = {https://doi.org/10.11648/j.iji.20180601.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20180601.11},
  abstract = {Cardiovascular disease is a leading cause of mortality in all ages worldwide. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) accounting for 10%. There have been several reports of neurological complications associated with TOF. Although it is known, brain abscess (BA) is a serious complication in patients with uncorrected CHD mostly in the age of 4-7 years-old. We report a case of a 7 year old male who presented with a 3 month history of left sided body weakness and a 3 week history of a headache and fever. Patient was chronically unwell since birth where he would experience occasional episodes of exertional dyspnoea which was never investigated. Chest xray showed a globular-shaped heart. CT scan brain showed a 1,8 x 1,3 x 1,5 cm ring-enhancing lesion in the right parietal region with minimal perilesional vasogenic edema communicating with the body of the lateral ventricle, with enhancement of the ependymal lining of the ventricle; echocardiography revealed ventricular septal defect (VSD), overriding of aorta, obstruction to right ventricular outflow tract and hypertrophy of right ventricle consistent with a diagnosis of TOF. We elected to manage the patient conservatively on intravenous antibiotics, Patient improved significantly neurologically and was transferred to the cardiothoracic surgeons for further management of TOF.},
 year = {2018}
}

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TY  - JOUR
T1  - Brain Abscess in Undiagnosed Tetralogy of Fallot
AU  - Kelvin Nemayire
AU  - Kantenga Dieu Merci Kabulo
AU  - Luxwell Jokonya
AU  - Patrice Ntenga
AU  - Aaron Masiiwe Musara
AU  - Kazadi Kaluile Ntenga Kalangu
Y1  - 2018/01/19
PY  - 2018
N1  - https://doi.org/10.11648/j.iji.20180601.11
DO  - 10.11648/j.iji.20180601.11
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20180601.11
AB  - Cardiovascular disease is a leading cause of mortality in all ages worldwide. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) accounting for 10%. There have been several reports of neurological complications associated with TOF. Although it is known, brain abscess (BA) is a serious complication in patients with uncorrected CHD mostly in the age of 4-7 years-old. We report a case of a 7 year old male who presented with a 3 month history of left sided body weakness and a 3 week history of a headache and fever. Patient was chronically unwell since birth where he would experience occasional episodes of exertional dyspnoea which was never investigated. Chest xray showed a globular-shaped heart. CT scan brain showed a 1,8 x 1,3 x 1,5 cm ring-enhancing lesion in the right parietal region with minimal perilesional vasogenic edema communicating with the body of the lateral ventricle, with enhancement of the ependymal lining of the ventricle; echocardiography revealed ventricular septal defect (VSD), overriding of aorta, obstruction to right ventricular outflow tract and hypertrophy of right ventricle consistent with a diagnosis of TOF. We elected to manage the patient conservatively on intravenous antibiotics, Patient improved significantly neurologically and was transferred to the cardiothoracic surgeons for further management of TOF.
VL  - 6
IS  - 1
ER  -

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Author Information

Kelvin Nemayire

Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Kantenga Dieu Merci Kabulo

Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Luxwell Jokonya

Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Patrice Ntenga

Neurological Clinic of the National Teaching Hospital-Fann, Dakar, Senegal
Aaron Masiiwe Musara

Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe
Kazadi Kaluile Ntenga Kalangu

Department of Neurosurgery, University of Zimbabwe, Harare, Zimbabwe

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APA Style

Kelvin Nemayire, Kantenga Dieu Merci Kabulo, Luxwell Jokonya, Patrice Ntenga, Aaron Masiiwe Musara, et al. (2018). Brain Abscess in Undiagnosed Tetralogy of Fallot. International Journal of Immunology, 6(1), 1-4. https://doi.org/10.11648/j.iji.20180601.11

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ACS Style

Kelvin Nemayire; Kantenga Dieu Merci Kabulo; Luxwell Jokonya; Patrice Ntenga; Aaron Masiiwe Musara, et al. Brain Abscess in Undiagnosed Tetralogy of Fallot. Int. J. Immunol. 2018, 6(1), 1-4. doi: 10.11648/j.iji.20180601.11

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AMA Style

Kelvin Nemayire, Kantenga Dieu Merci Kabulo, Luxwell Jokonya, Patrice Ntenga, Aaron Masiiwe Musara, et al. Brain Abscess in Undiagnosed Tetralogy of Fallot. Int J Immunol. 2018;6(1):1-4. doi: 10.11648/j.iji.20180601.11

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@article{10.11648/j.iji.20180601.11,
  author = {Kelvin Nemayire and Kantenga Dieu Merci Kabulo and Luxwell Jokonya and Patrice Ntenga and Aaron Masiiwe Musara and Kazadi Kaluile Ntenga Kalangu},
  title = {Brain Abscess in Undiagnosed Tetralogy of Fallot},
  journal = {International Journal of Immunology},
  volume = {6},
  number = {1},
  pages = {1-4},
  doi = {10.11648/j.iji.20180601.11},
  url = {https://doi.org/10.11648/j.iji.20180601.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20180601.11},
  abstract = {Cardiovascular disease is a leading cause of mortality in all ages worldwide. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) accounting for 10%. There have been several reports of neurological complications associated with TOF. Although it is known, brain abscess (BA) is a serious complication in patients with uncorrected CHD mostly in the age of 4-7 years-old. We report a case of a 7 year old male who presented with a 3 month history of left sided body weakness and a 3 week history of a headache and fever. Patient was chronically unwell since birth where he would experience occasional episodes of exertional dyspnoea which was never investigated. Chest xray showed a globular-shaped heart. CT scan brain showed a 1,8 x 1,3 x 1,5 cm ring-enhancing lesion in the right parietal region with minimal perilesional vasogenic edema communicating with the body of the lateral ventricle, with enhancement of the ependymal lining of the ventricle; echocardiography revealed ventricular septal defect (VSD), overriding of aorta, obstruction to right ventricular outflow tract and hypertrophy of right ventricle consistent with a diagnosis of TOF. We elected to manage the patient conservatively on intravenous antibiotics, Patient improved significantly neurologically and was transferred to the cardiothoracic surgeons for further management of TOF.},
 year = {2018}
}

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TY  - JOUR
T1  - Brain Abscess in Undiagnosed Tetralogy of Fallot
AU  - Kelvin Nemayire
AU  - Kantenga Dieu Merci Kabulo
AU  - Luxwell Jokonya
AU  - Patrice Ntenga
AU  - Aaron Masiiwe Musara
AU  - Kazadi Kaluile Ntenga Kalangu
Y1  - 2018/01/19
PY  - 2018
N1  - https://doi.org/10.11648/j.iji.20180601.11
DO  - 10.11648/j.iji.20180601.11
T2  - International Journal of Immunology
JF  - International Journal of Immunology
JO  - International Journal of Immunology
SP  - 1
EP  - 4
PB  - Science Publishing Group
SN  - 2329-1753
UR  - https://doi.org/10.11648/j.iji.20180601.11
AB  - Cardiovascular disease is a leading cause of mortality in all ages worldwide. Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD) accounting for 10%. There have been several reports of neurological complications associated with TOF. Although it is known, brain abscess (BA) is a serious complication in patients with uncorrected CHD mostly in the age of 4-7 years-old. We report a case of a 7 year old male who presented with a 3 month history of left sided body weakness and a 3 week history of a headache and fever. Patient was chronically unwell since birth where he would experience occasional episodes of exertional dyspnoea which was never investigated. Chest xray showed a globular-shaped heart. CT scan brain showed a 1,8 x 1,3 x 1,5 cm ring-enhancing lesion in the right parietal region with minimal perilesional vasogenic edema communicating with the body of the lateral ventricle, with enhancement of the ependymal lining of the ventricle; echocardiography revealed ventricular septal defect (VSD), overriding of aorta, obstruction to right ventricular outflow tract and hypertrophy of right ventricle consistent with a diagnosis of TOF. We elected to manage the patient conservatively on intravenous antibiotics, Patient improved significantly neurologically and was transferred to the cardiothoracic surgeons for further management of TOF.
VL  - 6
IS  - 1
ER  -

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