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Recurrent brain abscess induced by pulmonary arteriovenous fistula

Takanobu Kaido1, Yoshio Moriyama, Katsuhiro Ueda

  • 1Department of Neurosurgery, Oyodo Town General Hospital, Oyodo, Nara, Japan. kaido@ncnp.go.jp

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|January 25, 2011
PubMed

Insights

Recurrent brain abscesses can stem from pulmonary arteriovenous fistulas (PAVF). Prompt diagnosis and treatment of PAVF are crucial for resolving brain abscesses and preventing recurrence.

Area of Science:

  • Neurology
  • Cardiology
  • Infectious Diseases

Background:

  • Brain abscesses associated with arteriovenous fistulas (AVF) present diagnostic challenges and a high recurrence rate.
  • Pulmonary arteriovenous fistulas (PAVF) can be an uncommon yet significant source of recurrent brain abscesses.

Observation:

  • A 69-year-old female presented with a recurrent brain abscess, initially misdiagnosed.
  • Initial symptoms included a left cerebral peduncle mass and decerebrate rigidity, improving with antibiotics.
  • A subsequent episode of left hemiparesis led to the discovery of a right frontal lobe cystic mass.

Findings:

  • Surgical exploration confirmed a brain abscess.
  • Coil embolization successfully treated an underlying pulmonary arteriovenous fistula (PAVF).
  • The patient experienced significant improvement in hemiparesis post-embolization.

Implications:

  • This case highlights the importance of investigating for PAVF in recurrent brain abscesses.
  • Early detection and management of PAVF are essential for successful treatment and cure of associated brain abscesses.
  • Comprehensive etiological investigation is critical for managing complex neurological infections.

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