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Images in cardiology
Tuberculous brain abscess in an adolescent with complex congenital cyanotic heart disease
  1. Nayan Desai,
  2. Brian Gable,
  3. Matthew Ortman
  1. Department of Medicine, Cooper Medical School of Rowan University, Camden, New Jersey, USA
  1. Correspondence to Dr Nayan Desai, Division of Internal Medicine, Department of Medicine, Cooper Medical School of Rowan University, 3rd Floor E&R Bldg. 401 Haddon Ave, Camden, NJ 08103, USA; nayandesai_16{at}yahoo.co.in

http://dx.doi.org/10.1136/heartjnl-2013-303852

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    A 15-year-old boy presented with low-grade fever, frontal headache and projectile vomiting. Physical examination revealed clubbing, central cyanosis and systolic murmur at the base of the heart. Twelve-lead electrocardiography revealed rightward P wave axis, prominent anterior precordial forces with an R/S ratio in V1 approaching 1, and reverse precordial progression, suggestive of dextrocardia (figure 1), and confirmed by chest roentgenogram (figure …

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    Footnotes

    • Contributors ND: Literature search, writing the primary draft and image selection. BG and MO: review and correction of the manuscript.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; internally peer reviewed.