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Cerebral abscess and thrombophilia in pregnancy. A case report
L V Baxi1, S A Mayer, M Mansukhani
1Departments of Obstetrics and Gynecology, Neurology and Pathology, College of Physicians and Surgeons, Columbia University, Sloane Hospital for Women, New York Presbyterian Hospital, New York, New York, USA. lvbl@columbia.edu
Background:
Cerebral abscess in pregnancy is a rare event, with the etiology not well described. We present such a case in association with genetic thrombophilia.
Case:
A 36-year-old primigravida with a prior history of bilateral popliteal vein thrombosis and pulmonary embolism presented in early gestation with right hemiparesis, aphasia, disseminated intravascular coagulation and a space-occupying lesion in the left temporal lobe. Stereotactic biopsy confirmed the presence of an abscess. The patient also had a homozygous methylene tetrahydrofolate reductase mutation (C677T), protein S deficiency and lupus anticoagulant, all of which possibly contributed to the thrombosis, infarct, infection and abscess. She was successfully treated with low-molecular-weight heparin and antibiotics and had a term vaginal delivery.
Conclusion:
Recently genetic thrombophilia was reported in association with various complications of pregnancy, but it has never before been described as occurring with a cerebral abscess.