PT  - JOURNAL ARTICLE
AU  - Kara Morgan Ryan
AU  - Eugenia Siegler
TI  - Pyogenic brain abscess associated with an incidental pulmonary arteriovenous malformation
AID  - 10.1136/bcr-2022-252794
DP  - 2022 Nov 01
TA  - BMJ Case Reports
PG  - e252794
VI  - 15
IP  - 11
4099  - http://casereports.bmj.com/content/15/11/e252794.short
4100  - http://casereports.bmj.com/content/15/11/e252794.full
SO  - BMJ Case Reports2022 Nov 01; 15
AB  - 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.