Case 254

Medical history

A 12-year-old male patient sought Emergency Care due to non-thermometrated fever, headache, irritability, prostration and photophobia with start 8 days ago. He has used azithromycin due to sinusitis for 5 days and denies comorbidities or allergies. The first exam showed: neck stiffness, positive Brudzinski and Kernig signs, AP: 100x60 mmHg, HR: 65 bpm. Performed lumbar puncture which cerebrospinal fluid examination revealed pleocytosis with a predominance of neutrophils, glucose at 45mg/dL and proteins at 105mg/dL. Treatment with ceftriaxone was initiated, but the patient subsequently developed 3 episodes of tonic-clonic seizures, papilledema, and loss of strength in the right lower limb. Computed tomography of the brain was requested for the propaedeutic extension.



Question:
In view of the clinical picture presented and the changes observed in computed tomography, what is the most likely complication?

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