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Multiple brain abscesses: an initial presentation in a child with an undiagnosed sinus venosus atrial septal defect

Rukhsana Abdullah1, Mary Baldauf, Shabana Azam

  • 1Brookdale University Hospital and Medical Center, Department of Pediatrics, 1 Brookdale Plaza, Brooklyn, NY 11212, United States.

Clinical Neurology and Neurosurgery
|June 30, 2007
PubMed

Insights

Multiple brain abscesses in a child were linked to an undiagnosed atrial septal defect (ASD). This case highlights the importance of cardiac evaluation, including transesophageal echocardiogram, for idiopathic cerebral abscesses in children.

Area of Science:

  • Neurology
  • Pediatrics
  • Cardiology

Background:

  • Cerebral abscess is a severe neurological condition, often associated with cyanotic congenital heart disease in children.
  • Idiopathic cerebral abscesses in pediatric patients warrant thorough investigation into potential underlying causes.
  • Congenital heart defects can present atypically, even in asymptomatic individuals.

Observation:

  • A 12-year-old male presented with multiple cerebral abscesses.
  • Extensive evaluation, including transesophageal echocardiogram (TEE), revealed a previously undiagnosed sinus venosus atrial septal defect (ASD).
  • The patient had an asymptomatic, acynotic congenital heart defect.

Findings:

  • The patient was successfully treated with antibiotics for the brain abscesses.
  • This case represents an unusual presentation of an asymptomatic, acynotic congenital heart disease presenting initially as multiple brain abscesses.
  • Sinus venosus ASD was identified as the underlying cause in this pediatric patient.

Implications:

  • A comprehensive cardiac evaluation, including TEE with saline contrast, should be considered in the workup of pediatric idiopathic cerebral abscesses.
  • Early detection and management of congenital heart defects can potentially prevent serious neurological complications like brain abscesses.
  • This case underscores the importance of considering non-cyanotic congenital heart disease in the differential diagnosis of pediatric brain abscesses.

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