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Brain abscesses in a patient with a patent foramen ovale: a case report

Fuad Jan1, Abdul Moiz Hafiz, Saurabh Gupta

  • 1Department of Medicine, Division of Cardiovascular Disease, University of Wisconsin School of Medicine and Public Health, Milwaukee Clinical Campus, North 12th Street, Milwaukee, Wisconsin, 53233, USA.

Journal of Medical Case Reports
|January 12, 2010
PubMed
Abstract

Insights

A rare case of brain abscesses in an adult was linked to a patent foramen ovale, a heart defect allowing paradoxical microbial spread. This highlights a potential cause for recurrent brain infections.

Area of Science:

  • Neurology
  • Cardiology
  • Infectious Diseases

Background:

  • Brain abscesses are uncommon in adults, especially when associated with right-to-left cardiac shunting.
  • Periodontal disease can be a source of oral flora, a potential pathogen in brain infections.

Purpose of the Study:

  • To present a rare case of multiple brain abscesses in an adult.
  • To investigate the potential link between a patent foramen ovale and brain abscesses.
  • To explore the mechanism of paradoxical microbial dissemination.

Main Methods:

  • Case report of a 47-year-old male with periodontal disease and Streptococcus intermedius brain abscesses.
  • Comprehensive diagnostic workup including cardiac evaluation.
  • Literature review on patent foramen ovale and brain abscesses.

Main Results:

  • A patent foramen ovale was identified as the likely source of right-to-left shunting.
  • Oral flora was implicated as the causative agent, originating from periodontal disease.
  • Multiple brain abscesses were successfully treated.

Conclusions:

  • A silent patent foramen ovale may facilitate paradoxical microbial dissemination to the brain.
  • This association could explain otherwise cryptogenic brain abscesses.
  • Early detection of cardiac shunts may be crucial in managing recurrent brain infections.

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