Objective: To look at the clinical profile, microbiology and outcome of children with cerebral abscess having an underlying congenital heart disease (CHD).

Subjects and methods: Retrospective study, which included all CHD patients with brain abscess over 6 years. The data analyzed in terms of their clinical presentation, predisposing factors, lab parameters, treatment modalities and outcome.

Result: 18 subjects with mean age was 9 years(4.5 to 18 years) included. Presenting symptoms were :headache 14 (75%) ,vomiting 9 (50%) , fever , focal deficits , seizures . 13 cases were observe in cyanotic CHD , 8 cases in TOF , 5 cases in univentricular cyanotic CHD, 5 cases were associated with acyanotic CHD, 4 VSD, left to right shunt , 1 case of complete AV canal defect. Polycythemia was present in 11 patients (62%). The causative organism most commonly found was strept, Most common sites were left frontoparietal region (8, 45%), frontal abscesses 8,45%, parietal location, 39%, temporal lobe 3,17% patients and occipital location 1,5%. All abscesses were > 2 cm. Midline shift and cerebral edema was noted in 3. Abscess was drained by burr hole in 14 ,78% , repeated drainage and excision in 3 ,17% patients. Duration of hospitalization was CHD patients.The overall bad prognostic features included deranged sensorium, midline shift and cerebral edema.
CONCLUSION:A high index of suspicion is required for diagnosis. Abscesses in CHD patients are generally single and large abscesses. Aspiration of the brain abscess has given good results in congenital heart disease patients in our series