Introduction

1. Soliter Brain Abscess in Children with Tetralogy of Fallot Dwi Fachri, Jimmy Passat, Irawan Mangunatmadja Department of Child Health, Faculty of Medicine, University of Indonesia Cipto Mangunkusumo Hospital, Jakarta Introduction Brain abscess is a focal, intracerebral infection that begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule Incidence of brain abscess in CHD is 5-18% CMH 2001-2007: 9 patients, 4 of them with Tetralogy of Fallot Case : a 6 year old boy CT Scan before surgery • Symptoms • Headache (+) and vomit (+) • Weakness of the right extremities • Involuntary movement and paresis • Physical examination • Alert, cyanotic • Funduscopy: papil edema (+)/(+) • Right cranial nerves paresis VI and VII • Ejection systolic murmur • Right hemiparesis, increased physiologic reflexes, clubbing finger • Laboratory examinations • Polycythemia and leukocytosis • The diameter of abscess was 4.5 x 5 cm) • there were midline shift to the right and perifocal edema Diagnosis • Soliter brain abscess • Tetralogy of Fallot Chest X-Ray Treatment • Cefotaxime, metronidazole, chloramphenicol for 8 weeks • Steroid for 2 weeks • Aspiration and antibiotic intralesion(gentamycin) • Physiotherapy • Cardiomegaly • Decreased vascular markings • Round elevated cardiac apex  Tetralogy of Fallot Follow up after 2 weeks of surgery • The diameter of abscess was reduced to 2.5x3.5 cm ( before 4.5x5 cm) • No midline shift to the right • Edema was reduced • Echocardiography • Tetralogy of Fallot Conclusion Brain abscess should be considered in children more than 2 years presenting neurological deficits with cyanotic congenital heart disease KONIKA Surabaya , 6-9 July 2008