Introduction: Patients with multiple brain abscesses and a secondary diagnosis of tetralogy of fallot (TOF) rarely occur fatal complications. Brain abscess is a very uncommon but potentially fatal infection of the brain parenchyma that can affect 5%-18.7% of the CHD population. The degree of right-to-left shunt is responsible for brain tissue hypoxia, which can lead to cerebral infarction, which is a precursor to cerebral abscess. Therefore, this study aimed to report on a patient with several brain abscesses and TOF.
Case description: A 30-year-old cyanotic male with a chief complaint of gradually decreased consciousness since 2 weeks ago without a history of vomiting. The patient has a clubbing finger. The patient has a TOF history without a prior infection, such as toothache, ear discharge, paranasal infection, cough, or flu. Physical examination revealed the Glasgow Coma Scale of E4VxM6 (global aphasia), right hemiparesis, increased physiological reflexes and positive pathological reflexes in the right of the body. Laboratory results showed slight leucocytosis and hyponatremia and elevated CRP. Head MRI spectroscopy was performed 3 days later, revealing multiple brain abscesses. The patient was given therapy antibiotics, namely ceftriaxone injection and metronidazole injection intravenously.
Conclusion: A brain abscess should be suspected in patients with TOF who arrive with a fever and an acute neurological condition. Besides antibiotics, patients should be encouraged to have corrective surgery as soon as possible to avoid future deadly consequences.