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[Brain abscess secondary to pulmonary arteriovenous malformation, case report (author's transl)]
Abstract:
A case of brain abscess in the right parietal lobe secondary to pulmonary arteriovenous malformation of the right lung is presented. A 27-year-old man was admitted for headache and left homonymous hemianopsia. CAG, VAG and brain scan detected brain abscess of the right parietal lobe which was successfully removed surgically. He had been noted to have generalized cyanosis and club finger which corresponded to polycytemia and hypercapnia on examination. Subsequently pulmonary arteriovenous malformation was found in the right lower lobe of the lung which was also successfully excised by thoracic surgeons. Brain abscess was caused by peptostreptococcus anaerobius.
Insights
A brain abscess caused by Peptostreptococcus anaerobius was successfully treated in a 27-year-old man. The abscess was secondary to a pulmonary arteriovenous malformation, which was also surgically removed.
Area of Science:
- Neurology
- Cardiology
- Infectious Diseases
Background:
- Pulmonary arteriovenous malformations (PAVMs) can lead to paradoxical embolism and brain abscess formation.
- Patients with PAVMs may present with cyanosis, clubbing, polycythemia, and hypercapnia due to right-to-left shunting.
- Brain abscess is a serious intracranial infection requiring prompt diagnosis and treatment.
Observation:
- A 27-year-old man presented with headache and left homonymous hemianopsia.
- Physical examination revealed generalized cyanosis and clubbing, indicative of polycythemia and hypercapnia.
- Cerebral angiography (CAG), vertebral angiography (VAG), and brain imaging confirmed a brain abscess in the right parietal lobe.
Findings:
- Surgical excision of the right parietal lobe brain abscess was successful.
- The underlying cause was identified as a pulmonary arteriovenous malformation in the right lower lobe, which was also surgically excised.
- Cultures from the brain abscess identified Peptostreptococcus anaerobius as the causative agent.
Implications:
- This case highlights the importance of considering PAVMs in young patients with neurological symptoms and cyanosis.
- Early diagnosis and management of both PAVMs and secondary brain abscesses are crucial for favorable outcomes.
- Multidisciplinary collaboration between neurologists, thoracic surgeons, and infectious disease specialists is essential for comprehensive patient care.