CLINICAL FEATURES AND OUTCOME OF CEREBRAL ABSCESS IN CONGENITAL HEART DISEASE
AbstractBackground: Cerebral abscess is a serious life threatening complication of several diseases. Theobjective of this study was to look at the clinical profile, microbiology and outcome of childrenwith cerebral abscess having an underlying congenital heart disease as compared to otherpredisposing conditions. Methods: Thirty children aged less than 15 years were reviewed. Therewere 15 males and 15 females. The mean age of presentation was 5.6±4.4 years. Results: Theduration of illness at the time of admission was 17.6±24.6 days. Typically patients presented withfever, vomiting, headache and seizures. The predisposing conditions found were cyanoticcongenital heart disease in 11 (37%) of children, meningitis in 6 (20%), septicemia in 7 (23%) andno underlying cause was found in 5 (17%) children. The most common microbe in children withcyanotic congenital heart disease was of the Streptococcus milleri group (52%). Computerizedtomography confirmed the diagnosis and the most common location of the abscess was theparietal lobe of the cerebral hemisphere. All abscesses were large, more than 2 cm in diameter andwere aspirated surgically. Excision was performed in 6 children. Five children expired, one due toa intracranial bleeding and the others due to severe cerebral edema and tentorial herniation.Complications were seen in 20 children and 16 had sequelae, hemiparesis in 11 and seizuredisorder in 5. Conclusion: Brain abscess is a serious infection with poor outcome if diagnosedlate. Delayed surgical drainage has high morbidity and mortality. The threshold for diagnosisshould be low particularly in children with a predisposing condition like cyanotic congenital heartdisease.Key words: Brain abscess, cyanotic congenital heart disease
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