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Brain abscess: a need to screen for pulmonary arteriovenous malformations
Mauro Gallitelli1, Vito Lepore, Giovanna Pasculli
1Department of Internal Medicine and Public Health, Internal Medicine 'A. Murri', University of Bari, Bari, Italy.
Background:
Pulmonary arteriovenous malformations (PAVMs) are direct connections between an artery and a vein in the pulmonary circulation associated with hereditary hemorrhagic telangiectasia in up to 88% of cases. Patients with PAVMs are at increased risk of brain abscess (BA). This study aimed to provide preliminary data on the prevalence of PAVMs among BA patients.
Methods:
Administrative hospital discharge forms were used to identify patients with BA; possible PAVM patients were screened.
Results:
126 patients with BA were identified. Two patients had undiagnosed PAVMs at the time of admission for BA. The age-adjusted incidence of BA was 6.3 cases/1 million/year, with a male:female ratio of 2.0.
Conclusion:
Although PAVMs are rare conditions, they play a role in the development of BA. PAVMs are usually not recognized at the time of BA, thus exposing patients to life-threatening risks.