Article Text

Reminder of important clinical lesson
An interesting case of cerebral abscess
  1. Muhammad Khizar Rafiq
  1. Royal Hallamshire Hospital, Neurology, Glossop Road, Sheffield, South Yorkshire, S10 2JF, UK
  1. Muhammad Khizar Rafiq, drmkrafiq{at}hotmail.com

Summary

An immigrant from Romania was referred to the neurosurgical unit with a cerebral abscess. On examination she was cyanosed and had clubbing of her fingers. A cardiovascular system examination revealed a systolic murmur heard all over the precordium. However, the diagnosis was not congenital cyanotic heart disease. The patient had a history of frequent nosebleeds and had multiple telangiectases on her body, leading to the diagnosis of hereditary haemorrhagic telangiectasia (HHT). A search was carried out for the presence of arteriovenous malformations in internal organs. Large arteriovenous malformations were found in the lungs, causing her cyanosis due to right-to-left shunting of blood and cerebral abscess due to paradoxical septic embolisation into cerebral circulation.

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Footnotes

  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.

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