24th International Intensive Care Symposium, İstanbul, Türkiye, 5 - 06 Mayıs 2023, ss.98
Trisomy 21, the presence of a supernumerary chromosome 21, results in a collection of clinical features commonly known as Down syndrome (DS). Among patients with DS, we know that intellectual disability and genetic risk factors for congenital heart disease are increased. Eisenmenger syndrome describes congenital heart disease associated severe pulmonary hypertension accompanied by right-to-left shunting. Patients with congenital cyanotic heart disease, like Eisenmenger syndrome, are at an increased risk of developing intra-cerebral abscesses. It is common practice for abscesses larger than 2 cm to undergo some form of surgical intervention, ranging from aspiration to excision of the abscess. Case: Thirty-one years old patient with known Down syndrome, VSD/ASD, Eisenmenger syndrome diagnoses presented the emergency department with numbness and dizziness in the right arms and legs. Cranial CT scan was performed and there was a 3.5x1.8 cm brain abscess in right lateral ventricle temporal horn in the inferior temporal gyrus of the right temporal lobe and extended into the ventricle was seen. The patient, who was taken to the intensive care unit due to the development of unstoppable seizure activity. The patient was intubated due to seizure activity. To the patient, appropriate antibiotic therapy was prescribed and extra ventricular drainage was placed by neurosurgeons. Patient was extubated after 13 days of antibiotic therapy and was discharged to the infectious diseases service, as the size of the abscess regressed in the control brain MRI. Discussion: In summary, we reported a rare clinical case report of brain abscess combined with Eisenmenger and DS, which has been successfully treated with intravenous antibiotics and timely ekstraventricular drenage implantation. In order to better understand and ultimately prevent occurrence of this potentially fatal syndrome.