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Recurrent brain abscess induced by pulmonary arteriovenous fistula

  • Case Report
  • Published:
Journal of Infection and Chemotherapy

Abstract

Brain abscess associated with an arteriovenous fistula (AVF) is sometimes difficult to diagnose and tends to recur. We report a case of recurrent brain abscess due to a pulmonary AVF (PAVF). A 69-year-old woman with a mass in the left cerebral peduncle had taken a progressively worse and shown decorticate rigidity. After an intravenous antibiotic for fever of unknown origin was changed, her condition gradually improved. She was discharged with the help of a cane. Thirty-one months later, she suffered left hemiparesis. Magnetic resonance imaging revealed a cystic mass in the right lateral frontal lobe. At surgery, we confirmed pus in the cyst. A PAVF was detected and was treated with coil embolization. The left hemiparesis improved and the postoperative course was uneventful. Exhaustive study is absolutely necessary to detect the etiology of recurrent brain abscess and to achieve a cure.

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References

  1. Caroli M, Arienta C, Rampini PM, Balbi S. Recurrence of brain abscess associated with asymptomatic arteriovenous malformation of the lung. Neurochirurgia (Stuttg). 1992;35:167–70.

    CAS  Google Scholar 

  2. Todo K, Moriwaki H, Higashi M, Kimura K, Naritomi H. A small pulmonary arteriovenous malformation as a cause of recurrent brain embolism. AJNR Am J Neuroradiol. 2004;25:428–30.

    PubMed  Google Scholar 

  3. Hall WA. Hereditary hemorrhagic telangiectasia (Rendu–Osler–Weber disease) presenting with polymicrobial brain abscess. Case report. J Neurosurg. 1994;81:294–6.

    Article  PubMed  CAS  Google Scholar 

  4. Swanson KL, Prakash UB, Stanson AW. Pulmonary arteriovenous fistulas: Mayo Clinic experience, 1982–1997. Mayo Clin Proc. 1999;74:671–80.

    Article  PubMed  CAS  Google Scholar 

  5. Preston DC, Shapiro BE. Pulmonary arteriovenous fistula and brain abscess. Neurology. 2001;56:418.

    PubMed  CAS  Google Scholar 

  6. Arivazhagan A, Pandey P, Anandh B, Abraham RG, Indira DB, Sampath S, Chandramouli BA, Varghese K. An unusual etiology of recurrent cerebral abscesses—a report of 3 cases. Surg Neurol. 2009;71:241–4 (discussion 5).

    Google Scholar 

  7. Kakar A, Byotra SP, Gupta A, Jain N. Pulmonary arteriovenous fistula presenting as multiple brain abscess. J Assoc Physicians India. 2003;51:626–8.

    PubMed  CAS  Google Scholar 

  8. Tsunezuka Y, Sato H, Tsukioka T. Strategy for 3-D computed tomography diagnosis and treatment of small pulmonary arteriovenous fistula. Scand Cardiovasc J. 2000;34:90–1.

    Article  PubMed  CAS  Google Scholar 

  9. Natarajan K, Khabiri H, Jung S. Case 3. Pulmonary arteriovenous malformation (PAVM): paradoxical embolism through the arteriovenous fistula can cause brain abscess and infarct. AJR Am J Roentgenol. 2000;175(854):7–8.

    Google Scholar 

  10. Kawano H, Hirano T, Ikeno K, Fuwa I, Uchino M. Brain abscess caused by pulmonary arteriovenous fistulas without Rendu–Osler–Weber disease. Intern Med. 2009;48:485–7.

    Article  PubMed  Google Scholar 

  11. Nakajima H, Iwai Y, Yamanaka K, Kishi H. Successful treatment of brainstem abscess with stereotactic aspiration. Surg Neurol. 1999;52:445–8.

    Article  PubMed  CAS  Google Scholar 

  12. Vaquero J, Cabezudo JM, Leunda G. Nonsurgical resolution of a brain-stem abscess. Case report. J Neurosurg. 1980;53:726–7.

    Article  PubMed  CAS  Google Scholar 

  13. Alapatt JP, Kutty RK, Jose B, Gopi P. A case of cerebral toxoplasmosis in a pregnant non-immunocompromised patient. Neurol Neurochir Pol. 2009;43:391–5.

    PubMed  Google Scholar 

  14. Jiang YG, Chen J, Peng Y. Tuberculous brainstem abscess: case report. Neurosurgery. 2009;65:E1206–7 (discussion E7).

    Google Scholar 

  15. Wait SD, Beres EJ, Nakaji P. Bacterial abscess of the medulla oblongata. J Clin Neurosci. 2009;16:1082–4.

    Article  PubMed  Google Scholar 

Download references

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Correspondence to Takanobu Kaido.

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Kaido, T., Moriyama, Y., Ueda, K. et al. Recurrent brain abscess induced by pulmonary arteriovenous fistula. J Infect Chemother 17, 552–554 (2011). https://doi.org/10.1007/s10156-011-0210-9

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  • DOI: https://doi.org/10.1007/s10156-011-0210-9

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