# A Rare Confluence: Brain Abscess in an Adult With Tetralogy of Fallot

## TL;DR

This case report describes a rare brain abscess in a 24-year-old with unrepaired Tetralogy of Fallot, emphasizing the need for early diagnosis and treatment to prevent severe complications.

## Contribution

The novelty lies in highlighting the rare but severe complication of brain abscess in an adult with unrepaired Tetralogy of Fallot.

## Key findings

- A 24-year-old female with unrepaired TOF presented with a brain abscess caused by Streptococcus intermedius.
- Early diagnosis and surgical repair of TOF are crucial to prevent life-threatening complications like brain abscess.
- NCCT imaging was effective in identifying the hypodense lesion and guiding urgent drainage.

## Abstract

Tetralogy of Fallot (TOF) is a common congenital heart disease (CHD) characterized by four distinct cardiac abnormalities. Brain abscess, though rare, is a life-threatening complication in patients with cyanotic congenital heart disease (CCHD), including TOF. This case report describes a 24-year-old female with unrepaired TOF who presented with symptoms of a brain abscess, including altered sensorium, fever, projectile vomiting, and headache. Diagnostic imaging with non-contrast-enhanced computed tomography (NCCT) revealed a well-defined hypodense lesion with a midline shift, prompting urgent drainage of the abscess. Subsequent cultures of the pus material identified Streptococcus intermedius as the causative agent, and the patient was maintained on antibiotics. This case highlights the importance of early diagnosis and surgical repair of TOF to prevent severe complications such as brain abscess, thereby reducing morbidity and mortality.