{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:18:26Z","timestamp":1780399106528,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":152,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tetralogy of Fallot (TOF) is a congenital heart anomaly usually corrected surgically in childhood. Reports of adults with unrepaired TOF indicate that they are at high risk of endocardial infections and sequelae such as distant abscesses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 63\u2010year\u2010old man born and raised in Vietnam presented with unrepaired TOF and 5\u2009days of dizziness, dysarthria, and left\u2010sided weakness. Magnetic resonance imaging (MRI) of the brain demonstrated a 2.9\u2010cm rim\u2010enhancing pontine lesion with associated edema and a punctate acute infarct in the right cerebellum. Echocardiogram of the heart revealed right\u2010to\u2010left shunting, while chest computerized tomography (CT) showed a left apical cavitary mass. Initial studies were negative for bacteremia and endocarditis. Due to clinical suspicion and a positive QuantiFERON Gold tuberculosis (TB) test, antituberculous therapy was initiated. Biopsy of the central nervous system (CNS) lesion was deferred due to risk, and therapy was continued with antituberculous agents and steroids. The patient improved with a final diagnosis of tuberculous brainstem abscess.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights early recognition and awareness of potential complications associated with untreated TOF as well as suspicion for TB in the proper clinical setting. Complex cases involving rare diagnoses should be approached systematically, evaluating possible diagnoses in order of urgency and basing invasive procedures on patient risk\u2013benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carm\/8475963","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T10:44:15Z","timestamp":1780397055000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Brainstem Tuberculous Abscess in a 63\u2010Year\u2010Old Adult With Unrepaired Tetralogy of Fallot"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7714-6169","authenticated-orcid":false,"given":"Jessica","family":"S. Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora","family":"Y. 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Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Ehrlich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gbambele","family":"Kone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.061143"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(78)90941-4"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.67063"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022445"},{"key":"e_1_2_11_5_2","first-page":"188","article-title":"Brain Abscess in Patients With Cyanotic Heart Defects","volume":"83","author":"Piper C.","year":"1994","journal-title":"Zeitschrift f\u00fcr Kardiologie"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0090-3019(89)90325-X"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960270413"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-011-0119-3"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjcpc.2023.12.002"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-202647"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2019-229421"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-1599"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1042\/BST20220830"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S368183"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7212a1"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0319"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70168-6"},{"key":"e_1_2_11_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2003.tb00185.x"},{"key":"e_1_2_11_19_2","doi-asserted-by":"publisher","DOI":"10.5114\/pjr.2018.81408"},{"key":"e_1_2_11_20_2","doi-asserted-by":"publisher","DOI":"10.4103\/0028-3886.51303"},{"key":"e_1_2_11_21_2","first-page":"9","article-title":"Tuberculous Meningitis in Tetralogy of Fallot: a Case Report","volume":"3","author":"Desphy M. 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