Cerebral Abscess (Paradoxic) Accompanying Congenital Heart Disease

Wechsler, I. S.

doi:10.1001/archinte.1940.00190180094007

Cited by 19 publications

(4 citation statements)

References 5 publications

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“…A pneumococcus was grown from one, and E. coli from two others: Maronde (1950) found the commonest organism was the streptococcus. Wechsler and Kaplan (1940), in a review, found such abscesses to be more common on the right than on the left, but this was not supported by Campbell (1957).…”

Section: The Tetralogy Of Fallotmentioning

confidence: 91%

Incidence of Congenital Heart Disease in Singapore

Muir¹

1960

Heart

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The diagnosis, and in many centres the surgical correction, of congenital heart disease is now commonplace. Several large series, both clinical and post-mortem, reporting the relative incidence of the various cardiac anomalies have now been published. Further, attempts have been made to estimate the absolute incidence of such anomalies in given populations, e.g. McMahon et al. (1953) in Birmingham and Carlgren (1959) in Gothenburg. Such data, in the main, relate to temperate climes, and to persons of Caucasian stock. Elsewhere little attention has been paid to such defects and ". . . there is little published work on the incidence of congenital malformations of the heart in tropical and sub-tropical areas . . ." (Williams and Simpkiss, 1958).This paper describes and classifies, from a morbid anatomical viewpoint, the 411 cases of congenital heart disease seen in 19,415 consecutive unselected necropsies performed at the General Hospital, Singapore, in the decade 1948-57. METHOD AND MATERIALThe data considered relevant were extracted from the post-mortem protocols and entered on specially prepared forms for subsequent analysis. As 17 per cent of the necropsies in this series were performed at the request of H.M. Coroner on children found dead, and as many of those admitted to the wards died less than four hours after admission, no attempt has been made to record clinical data.Singapore is a multiracial city. While theoretically one might expect that the post-mortem figures for a particular disease would reflect, by and large, the relative racial frequencies (Chinese 76.5%, Indians 8%, Malays 12%, and others 3.5%. in the 1957 census) in this series of 411 cases, 400 (97%/) were of Chinese race, 10 (2.4%) were of Indian stock, and 1 was a Malay, an absolute and relatively overwhelming preponderance of Chinese.If one examines, by race, the number of necropsies performed in Singapore, there is again an undue relative preponderance of Chinese, as the bodies of many Chinese children dying in hospital are not claimed and come to autopsy, as it were, by default. Further, for religious and other reasons it is much more difficult to obtain permission to examine the bodies ofIndians and Malays. Thus, although the data in this paper relate mainly to the Chinese population; it cannot be assumed that the incidence in Chinese is higher than in other races.The relative incidence of the lesions is shown in

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Section: The Tetralogy Of Fallotmentioning

confidence: 91%

Incidence of Congenital Heart Disease in Singapore

Muir¹

1960

Heart

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“…All these patients suffered from congenital heart disease which resulted in an arteriovenous shunt. It is assumed (Wechsler and Kaplan, 1940) that infected emboli during transient bacteraemia bypassed the pulmonary capillaries and reached the greater circulation and thus the brain via the congenital heart defect. Before the antimicrobial era this type of brain abscess was diagnosed only at necropsy (Beller, 1951 of the brain ( Table 2).…”

Section: Source Of Infectionmentioning

confidence: 99%

Brain abscess: Review of 89 cases over a period of 30 years

Beller

Sahar

Praiss

1973

Journal of Neurology, Neurosurgery & Psychiatry

158

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SUMMARY Eighty-nine cases of brain abscess, diagnosed over a period of 30 years, are reviewed. The incidence of this disease did not decline throughout the period. Abscesses of ear and nose origin constituted the largest group (38%). Postoperative abscesses seem to have increased in incidence, presumably due to routine postoperative antibiotic treatment. Antibiotics were possibly responsible for the suppression of signs of infection in 4500 of the patients, who presented as suffering from a space-occupying lesion. The most accurate diagnostic tool was angiography, which localized the lesion in 9000 and suggested its nature in 61%. Brain scan may prove as satisfactory.Staphylococcus was cultured in about two-thirds of the cases. Mortality seemed to decrease concomitantly with the advent of more potent antibiotics. The treatment of choice in terms of both mortality and morbidity seemed to be enucleation after previous sterilization. The hazards of radical surgery should be taken into consideration.

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“…Lallemand Louis and Berthody [11] [12] reported two cases in 1923 and Rabinowitz and associates [13] were the first to report a case with correct antemortem diagnosis in 1932. Wechsler and Kaplan [14] described two cases in 1940.…”

Section: Review Of Literaturementioning

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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Cerebral Abscess (Paradoxic) Accompanying Congenital Heart Disease

Cited by 19 publications

References 5 publications

Incidence of Congenital Heart Disease in Singapore

Incidence of Congenital Heart Disease in Singapore

Brain abscess: Review of 89 cases over a period of 30 years

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

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