Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지

A Multi-organ Abscesses Including Brain Caused by a Congenital Pulmonary Arteriovenous Fistula

  • Kim, Hyung-Suk (Department of Neurosurgery. St. Vincent's Hospital, The Catholic University of Korea) ;
  • Sung, Jae-Hoon (Department of Neurosurgery. St. Vincent's Hospital, The Catholic University of Korea) ;
  • Son, Byung-Chul (Department of Neurosurgery. St. Vincent's Hospital, The Catholic University of Korea) ;
  • Lee, Sang-Won (Department of Neurosurgery. St. Vincent's Hospital, The Catholic University of Korea)
  • Published : 2005.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

In cases of brain or other organ abscess, the causative etiology or disease are not always definable. We report a case of brain, renal, and possibly lung abscesses in a middle aged woman. After close, stepwise surveillance of possible etiologic factors, we covered out a small solitary pulmonary arteriovenous fistula without any pulmonary symptoms and successfully occluded the fistula via endovascular approach. The congenital pulmonary arteriovenous fistula should be bear in mind as a cause of repeated, multiple systemic infective source spray and be pursued despite of negative initial baseline studies.

Keywords

References

  1. Dines DE, Arms RA, Bernatz PE, Gomes MR : Pulmonary arteriovenous fistulas. Mayo Clin Proc 49 : 460-465, 1974
  2. Dyer NH : Cerebral abscess in hereditary haemorrhagic telangiectasia : report of two cases in a family. J Neurol Neurosurg Psychiatry 30 : 563-567, 1967 https://doi.org/10.1136/jnnp.30.6.563
  3. Fraser RS, Pare JAP, Fraser RG, Pare PD : Synopsis of diseases of the chest, ed 2. Philadelphia : W. B. Saunders, 1994, pp277-279
  4. Fuentes Pradera MA, Otero Candelera R, Ortega Ruiz F, Franco E : Cerebral abscess as first manifestation of a familial pulmonary arteriovenous fistula. Arch Bronconeumol 35 : 407-409, 1999 https://doi.org/10.1016/S0300-2896(15)30059-4
  5. Hall WA : Hereditary hemorrhagic telangiectasia (Rendu-Osler- Weber disease) presenting with polymicrobial brain abscess. Case report. J Neurosurg 81 : 294-296, 1994 https://doi.org/10.3171/jns.1994.81.2.0294
  6. Han S, Lim D, Chung Y, Cho T, Lim S, Kim W, et al : The multiple brain abscessed associated with congenital pulmonary arteriovenous malformations : A case report. J Korean Med Sci 17 : 407-411, 2002 https://doi.org/10.3346/jkms.2002.17.3.407
  7. Higgins CB, Wexler L : Clinical and angiographic features of pulmonary arteriovenous fistulas in children. Radiology 119 : 171-175, 1976 https://doi.org/10.1148/119.1.171
  8. Khurshid I, Downie GH : Pulmonary arteriovenous malformation. Postgrad Med J 78 : 191-197, 2002 https://doi.org/10.1136/pmj.78.918.191
  9. Natarajan K, Khabiri H, Jung S : Case 3. Pulmonary arteriovenous malformation (PAVM) : paradoxical embolism through the arteriovenous fistula can cause brain abscess and infarct. AJR Am J Roentgenol 175 : 857-858, 2000 https://doi.org/10.2214/ajr.175.3.1750857
  10. Press OW, Ramsey PG : Central nervous system infections associated with hereditary hemorrhagic telangiectasia. Am J Med 77 : 86-92, 1984 https://doi.org/10.1016/0002-9343(84)90441-8
  11. Remy J, Remy-Jardin M, Giraud F, Wattinne L : Angioarchitecture of pulmonary arteriovenous malformations: clinical utility of threedimensional helical CT. Radiology 191 : 657-664, 1994 https://doi.org/10.1148/radiology.191.3.8184042
  12. Shibasaki I, Kase K, Ohtsuka A, Nakayama M : A case of pulmonary arteriovenous fistula associated with cerebellar abscess. Kyobu Geka 52 : 512-515, 1999
  13. Swanson KL, Prakash UB, Stanson AW : Pulmonary arteriovenous fistulas : Mayo Clinic experience, 1982-1997. Mayo Clin Proc 74 : 671-680, 1999 https://doi.org/10.4065/74.7.671
  14. Taylor BG, Cockerill EM, Manfredi F, Klatte EC : Therapeutic embolization of the pulmonary artery in pulmonary arteriovenous fistula. Am J Med 64 : 360-365, 1978 https://doi.org/10.1016/0002-9343(78)90066-9
  15. White RI Jr : Pulmonary arteriovenous malformations : how do we diagnose them and why is it important to do so? Radiology 182 : 633-635, 1992 https://doi.org/10.1148/radiology.182.3.1535872
  16. Yoon SH, Lee HJ, Yi JS, Yang JH, Lee IW, Song KS, et al : A case of brain abscess in a patient with primary mucociliary transport failure-A case report. J Korean Neurosurg Soc 30 : 1430-1434, 2001