Antibiotics for brain abscesses in people with cyanotic congenital heart disease

Lumbiganon, Pagakrong; Chaikitpinyo, Arnkisa

doi:10.1002/14651858.cd004469.pub3

Cited by 19 publications

(19 citation statements)

References 37 publications

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“…Regarding antibiotic therapy for the past 20 years high dose intravenous penicillin G and chloramphenicol have been used to treat brain abscess in this setting with satisfactory outcomes [14].…”

Section: Discussionmentioning

confidence: 99%

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Brain Abscess in Undiagnosed Tetralogy of Fallot

Nemayire¹,

Kabulo²,

Jokonya³

et al. 2018

IJI

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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.

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Section: Discussionmentioning

confidence: 99%

“…Actually, metronidazole is usually combined with third generation cephalosporins or penicillin G for the treatment of the patients with cyanotic heart disease complicated with BA [14]. The third generation cephalosporins are much more expensive than penicillin G there is a need to evaluate their effects [15].…”

Section: Discussionmentioning

confidence: 99%

Brain Abscess in Undiagnosed Tetralogy of Fallot

Nemayire¹,

Kabulo²,

Jokonya³

et al. 2018

IJI

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“…In cyanotic CHD, the presence of an intracardiac right-left shunt let the bacteria escape the filter represented by alveolar macrophages in the lungs. 9 One study demonstrated an impairment of phagocytic and bactericidal function in the leucocytes of infants affected by cyanotic CHD. 9 This kind of CHD often leads to development of complications involving the central nervous system, most often brain abscesses.…”

Section: Discussionmentioning

confidence: 99%

“…9 One study demonstrated an impairment of phagocytic and bactericidal function in the leucocytes of infants affected by cyanotic CHD. 9 This kind of CHD often leads to development of complications involving the central nervous system, most often brain abscesses. 10 With regard to noncyanotic cardiopathies, in the literature, a few cases of cerebral abscess associated with an interventricular communication or an interatrial communication have been reported.…”

Section: Discussionmentioning

confidence: 99%

Bacteremia, without Endocarditis, due to Streptococcus gallolyticus Subspecies gallolyticus in an Infant with Tetralogy of Fallot

Rizzo

Caprio

Carannante

et al. 2017

J Pediatr Infect Dis

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Streptococcus gallolyticus subspecies gallolyticus (SGSG) is a rare cause of bacteremia in infants. We are reporting a case of bacteremia without endocarditis in a patient affected by tetralogy of Fallot. In the suspect of cerebral involvement, a brain image study might be useful to rule out brain abscesses or embolism. When antibiotic treatment is promptly started, prognosis is good, even with only 2 weeks of effective antibiotic therapy.

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“…Pulmonary circulation represents a potential filtering apparatus for systemic bacterial pathogens. In patients with right-to-left shunts, absence of pulmonary phagocytic clearance of pathogens can occur and the ischemic injury from hypoxaemia and polycythaemia, produce low perfusion areas (microinfarcts) in the brain which may act as a nidus for infection [18]. In the development of brain abscess, inoculation of an organism is required into the brain parenchyma in an area of devitalized brain tissue or in a region with poor microcirculation and the seeded microorganisms can sustain growth and multiply to form abscess.…”

Section: Etiopathogenesismentioning

confidence: 99%

Infective Endocarditis in Tetralogy of Fallot Complicating Brain Abscess—A Case Report

Muthiah¹

2019

CRCM

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Aim: To report a case of solitary, parietal lobe abscess in a boy, aged 16 years in Tetralogy of Fallot. Introduction: Infective endocarditis is a serious and fatal complication in congenital heart disease. Following bacterial endocarditis, ventricular septal defect (VSD) and Tetralogy of Fallot (TOF) have less morbidity and higher survival rate in children. Neurological complications were recognized in 20% of cases and brain abscess is a serious infection of brain parenchyma as a result of seeding of infective pathogens in the shunted blood from the right side of the heart. Case Report: A 16 year old boy had Tetralogy of Fallot, presented with altered sensorium of sudden onset. Echocardiography revealed a large vegetation, attached to the ventricular septum and a large VSD with overriding of aorta. CT brain revealed a large abscess cavity in the parietal lobe, which was evacuated by aspiration and treated with antibiotics. Conclusion: Any patient presented with altered sensorium in cyanotic congenital heart disease must be evaluated with CT scanning for brain abscess and also check hematocrit to rule out hyperviscosity syndrome. Lumbar puncture has been considered hazardous in patients with brain abscess and usually performed under a strong suspicion of meningitis or ventriculitis in the absence of increased intracranial pressure.

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Antibiotics for brain abscesses in people with cyanotic congenital heart disease

Cited by 19 publications

References 37 publications

Brain Abscess in Undiagnosed Tetralogy of Fallot

Brain Abscess in Undiagnosed Tetralogy of Fallot

Bacteremia, without Endocarditis, due to Streptococcus gallolyticus Subspecies gallolyticus in an Infant with Tetralogy of Fallot

Infective Endocarditis in Tetralogy of Fallot Complicating Brain Abscess—A Case Report

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