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.

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

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