Abstract Ref Number = APCP1102
CEREBRAL EMPYEMA AS AN IMPACT OF SIANOTIC CONGENITAL HEART DISEASE ET CAUSA PENTALOGY OF FALLOT
Background : Pentalogy of Fallot is characterized by VSD, PS, Overriding Aorta, RVH, ASD, or PFO or PDA.One impact of POF is cerebral abcess which causes cerebral empyema. The incidence was 1,1 per 100.000 people each year with mortality rateof 37% in USA
Case Presentation Summary : A girl 1 year old, admitted to ERIA Department of Pediatric Department of Dr. Wahidin Sudirohusodo hospital with the chief complaint: unconscious since 2 days before admitted. From physical examinations, she was unconscious, fever, dyspneu, sianotic, clubbing fingers, and there was ejection systolic murmur. Laboratory examination revealed polycythemia (Hb 17,7 g/dl, HCT 57,1%). Cerebral Liquor Analysis showed increased leucocyte level. Echocardiography showed RVH, 3 mm ASD, 14-15 mm VSD, overriding aorta <50%, and severe PS. Head CT Scan showed signs of intraventricular lateral bilateral empyema DD/chronic hematoma. The patient treated with antibiotic and propanolol. Weekly evaluation showed significant improvements of clinical features, and after 17 days hospitalization her condition was good enough for outpatient care.
Learning Points/Discussion : -Pentalogy of fallot is variant of TOF and can also cause cerebral abscess such as cerebral empyema. -Cerebral empyema could give increased intracranial pressure signs and it was one of child emergencies. -Early recognition and intervention could save the child.
Keywords: Pentalogy of fallot Cerebral empyema Systolic murmur