Multiple brain abscesses in a patient with bilateral pulmonary arteriovenous malformations and immunoglobulin deficiency

Postgrad Med J. 2003 Oct;79(936):597-9. doi: 10.1136/pmj.79.936.597.

Abstract

A 34 year old Chinese man presented with grand mal seizures complicating multiple brain abscesses caused by mixed oral flora. Because of persistent hypoxaemia contrast spiral thoracic computed tomography was done, which revealed bilateral pulmonary arteriovenous malformations (PAVMs). Concomitant IgA and IgG subclass deficiency was also found. The combination of these two conditions appears to have predisposed this patient to presumably paradoxical septic embolism. The patient's cerebral condition responded to postoperative antibiotic treatment and he eventually received selective coil embolisation of right lower lobe PAVMs, which relieved his hypoxaemia and dyspnoea.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Arteriovenous Malformations / complications*
  • Arteriovenous Malformations / diagnosis
  • Arteriovenous Malformations / therapy
  • Brain Abscess / complications*
  • Brain Abscess / diagnosis
  • Dyspnea / etiology
  • Dyspnea / therapy
  • Embolization, Therapeutic / methods
  • Humans
  • Hypoxia / etiology
  • Hypoxia / therapy
  • IgA Deficiency / complications*
  • IgG Deficiency / complications*
  • Magnetic Resonance Angiography / methods
  • Male
  • Pulmonary Artery / abnormalities*
  • Tomography, X-Ray Computed / methods