The Double Threat: Multiple Brain Abscesses and Pulmonary AVM - A Rare Neuro-Pulmonary Connection Case Report

Background: Brain Abscess is defined as focal area of necrosis caused by a collection of pus, also known as Suppurative Encephalitis. The most common causes of brain abscesses are trauma, contiguous spread such as dental infections, paranasal sinusitis, otitis, mastoiditis, intracranial neurosurgical procedures, or hematogenous spread in cases of an Arteriovenous (AV) shunt, such as an Atrial Septum Defect. Pulmonary Arteriovenous Malformations (PAVMs) are direct abnormal vascular connection between a pulmonary artery and pulmonary vein, this connection bypasses the normal pulmonary capillary bed and results in an intrapulmonary right-to-left shunt. As a consequence, patients with PAVM can have hypoxemia and paradoxical embolization complications, including stroke and brain abscess. Despite, A Pulmonary Arteriovenous Malformation (PAVM) is an uncommon additional cause of AV shunt that may enable brain abscess. We report a case of a patient who was diagnosed with Brain Abscess along with Pulmonary AVM as a presenting manifestation. Case Presentation: A 28-year-old female presented with complain of fever, occipital Headache, vomiting and left sided weakness along with jerky movements of limbs. She was diagnosed was Brain Abscess in right superior front-parietal and left temporal regions. Craniotomy with evacuation of abscess was done, after few days her oxygen saturation was continuously dropping. Her Routine workup did not reveal any additional pathology apart from the PAVM. After treatment of the cerebral abscess, the PAVM was treated with embolization.