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Pyogenic brain abscess associated with an incidental pulmonary arteriovenous malformation
  1. Kara Morgan Ryan1 and
  2. Eugenia Siegler2
  1. 1Internal Medicine, Weill Cornell Medicine, New York, New York, USA
  2. 2Geriatrics, Weill Cornell Medical College, New York, New York, USA
  1. Correspondence to Dr Kara Morgan Ryan; kmr9020{at}


Pulmonary arteriovenous malformations (PAVMs) are rare and often asymptomatic vascular anomalies that can be associated with serious neurological consequences due to right-to-left shunting. We report a case of a woman in her 80s without substantial medical history who presented with a headache, weakness and personality changes, and was found to have a pyogenic brain abscess requiring emergent neurosurgical evacuation. The abscess grew oral flora, suspected to have reached the brain via an incidentally discovered PAVM. With drainage and antibiotics, the patient achieved a full recovery and the PAVM was embolised. To our knowledge, this is the oldest presentation of a PAVM-associated brain abscess in the published literature. Older patients may present without the typical signs and symptoms of a given illness, which complicates accurate diagnosis and treatment. Primary care physicians can help facilitate timely care and positive clinical outcomes.

  • Geriatric medicine
  • Infectious diseases
  • Infection (neurology)
  • Neurosurgery
  • Respiratory medicine

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  • Contributors All authors listed on the title page contributed equally. The patient was under the care of KR and ES. Report was written by KMR and ES.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.