COVID-19 neurological manifestations vary from mild symptoms, such as fatigue, to severe complications. This article presents a case of a 15-year-old male with multiple brain abscesses, meningitis, massive sinusitis and saggital sinus thrombosis. SARSCoV- 2 IgM and IgG antibodies were increased, while blood and CSF cultures, anti-HSV antibodies and IGRA were negative. The patient responded well to the initial treatment with broad-spectrum antibiotics, glucocorticoids and intravenous immunoglobulins. After two weeks, his clinical state sudd0enly collapsed, with the progression of purulent lesions in the MRI. Urgent craniotomy was performed. A follow-up MRI confirmed regression of the purulent lesions. Negative blood and CSF cultures, as well as insufficiency of the broad-spectrum antibiotic therapy, suggested an atypical or opportunistic CNS infection, characteristic of immunocompromised patients. This strengthens the hypothesis that SARS-CoV-2 infection may lead to decreased immunocompetence.
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