Multiple brain abscesses: An initial presentation in a child with an undiagnosed sinus venosus atrial septal defect

Cerebral abscess is a serious condition and in children the commonest cause is cyanotic congenital heart disease. We report a 12-year old male who presented with multiple brain abscesses. After an extensive evaluation including a transesphageal echocardiogram (TEE), we found a previously undiagnosed sinus venous atrial septal defect (ASD). He was treated medically with antibiotics. This is an unusual initial presentation of asymptomatic acynotic congenital heart disease in children. We recommended a complete cardiac evaluation including TEE with saline contrast study in the work up of an idiopathic cerebral abscess.