Screening in cryptogenic brain abscess: Do not forget pulmonary arteriovenous malformations.
Surg Neurol Int
; 12: 188, 2021.
Article
in English
| MEDLINE | ID: covidwho-1210044
ABSTRACT
BACKGROUND:
Brain abscess usually occurs secondary to trauma, through contiguous spread (e.g.; dental infections, [paranasal] sinusitis, otitis, and mastoiditis), after intracranial neurosurgical procedures, or through hematogenous spread in case of an arteriovenous (AV) shunt, for example; atrial septum defect. Although uncommon, another possible cause of AV shunt which can facilitate brain abscess is a pulmonary arteriovenous malformation (PAVM). We report a case of brain abscess secondary to a solitary PAVM and review the literature. CASE DESCRIPTION A 74-year-old male patient presented with headaches, fatigue, low-grade fever, and homonymous hemianopsia. He was diagnosed with a brain abscess in the left occipital lobe. A chest computed tomography (CT) with intravenous (IV) contrast was performed because of fever and respiratory insufficiency in a period where screening for COVID-19 in suspected patients was important. A solitary PAVM of the left lung was diagnosed. Initial stereotactic burr hole drainage of the abscess was insufficient and resection of the abscess was deemed necessary. Routine workup did not reveal any additional pathology apart from the PAVM. After treatment of the cerebral abscess, the PAVM was treated with embolization using an endovascular plug.CONCLUSION:
It is recommended to screen for PAVM by chest CT with IV contrast in patients with brain abscess when no obvious source of infection can be identified.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Case report
Language:
English
Journal:
Surg Neurol Int
Year:
2021
Document Type:
Article
Affiliation country:
SNI_51_2021
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