Brain abscesses in children with cyanotic congenital heart disease

Abstract

Brain abscess is a serious infection of the brain parenchyma that can occur in children with cyanotic congenital heart disease (CCHD). In children with CCHD, brain abscesses are often caused by the direct extension of an adjacent infection, or by distant hematogenous dissemination. In the present review, we discuss the epidemiology, etiology, clinical features, radiologic features, current treatments, and outcomes of brain abscesses associated with CCHD in children. Common clinical presentations of brain abscesses with CCHD include a fever, vomiting, headache, hemiparesis, and focal seizures. The most common causative microorganisms of brain abscesses are Streptococcus and Staphylococcus species. The radiologic features of brain abscesses in children with CCHD are a ring enhancing, well-defined lesion with a hypodense center; this is usually accompanied by surrounding cerebral edema. Appropriate surgery and antibiotic treatment are the gold standard for treating brain abscesses in children with CCHD. In addition, the early recognition of such brain abscesses is very important for their timely clinical treatment. Brain imaging techniques, including magnetic resonance imaging and computed tomography, are crucial for the early recognition of brain abscesses in CCHD.