Work

Cerebral Abscess Formation in Unrepaired Tetralogy of Fallot: Diagnosis and Management in a Low‐Resource Setting

Year: 2026

Type: article

Abstract: ABSTRACT From a neuroimaging perspective, a brain abscess remains a rare but life‐threatening complication of cyanotic congenital heart disease (CCHD), with Tetralogy of Fallot (TOF) the most common predisposing cardiac lesion. This report details the case of a 3‐year‐old male with unrepaired TOF who presented with an acute decreased level of consciousness and focal neurological deficits, notably without fever. This case illustrates the association between CCHD and paradoxical septic embolization to the brain and highlights the practical utility of computed Tomography (CT) in emergent, resource‐constrained settings where magnetic resonance imaging (MRI) is not immediately available. Non‐contrast and contrast‐enhanced CT in this patient demonstrated findings suggestive of multiple brain abscesses, directly guiding emergent neurosurgical intervention. While CT cannot definitively characterize abscesses with the same specificity as MRI, particularly in excluding necrotic neoplasms, the combination of multifocal ring‐enhancing lesions at the gray‐white matter junctions in a child with known TOF created a high pretest probability for pyogenic abscess. We emphasize the pathophysiological link between right‐to‐left shunting and multifocal CNS infection and discuss the decision‐guiding role of CT imaging when it is the only available cross‐sectional modality of investigation.

Source: Clinical neuroimaging.

DOI: 10.1002/neo2.70084

Authors: Mwanikha Fred, Ampuriire Nyakubaho, Ayikoru Brendah, Kisembo Harriet

Institutions: Ernest Cook University, Makerere University

Language: English

Topic: Congenital Heart Disease Studies

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,100