Meningitis and brain abscess: First but fatal presentation in a child with tetralogy of fallot.

Brain abscess is a known complication of cyanotic congenital heart diseases. We report the case of a four-year-old girl whose first presentation in the hospital was because of symptoms referable to the neurological system. These symptoms are similar to those seen in cerebral malaria as well as other infections of the central nervous system, e.g. meningitis and encephalitis. Detailed history, painstaking examination, and investigations will however help in differentiating these conditions. In the index case however, the illness was fatal due to the late presentation, which is not uncommon in this environment. In a resource-poor environment such as Nigeria, this is a reminder that proper history taking, clinical examination, and subsequent investigations will aid in early diagnosis and subsequent management of such cases to reduce childhood mortality. It also underscores the need for increased awareness among primary health care providers. <Learning objective: In developing countries where definitive treatments for most congenital heart diseases are not available, complications such as brain abscesses are not uncommon. Primary health care givers should be aware of these complications in these patients. Symptoms such as headaches, fever, and convulsions are common in children living in malaria endemic regions and may mimic the symptoms seen in brain abscess. A high index of suspicion is required to make prompt diagnosis and give appropriate treatment while treating children with congenital heart disease.>.