Pulmonary arteriovenous malformations in patients with previous brain abscess: a cross-sectional population-based study

被引:2
作者
Bodilsen, Jacob [1 ,16 ]
Madsen, Trine [2 ]
Brandt, Christian Thomas [3 ,4 ]
Mullertz, Katrine [5 ]
Wiese, Lothar [3 ]
Demirci, Semra Turan [6 ]
Suhrs, Hannah Elena [6 ]
Larsen, Lykke [7 ]
Gill, Sabine Ute Alice [8 ]
Hansen, Birgitte Ronde [9 ]
Nilsson, Brian [10 ]
Omland, Lars Haukali [11 ]
Fosbol, Emil [12 ,13 ]
Kjeldsen, Anette Drohse [14 ]
Nielsen, Henrik [1 ,15 ]
机构
[1] Aalborg Univ Hosp, Dept Infect Dis, Aalborg, Denmark
[2] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark
[3] Zealand Univ Hosp, Dept Infect Dis, Roskilde, Denmark
[4] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
[5] Nordsjaellands Hosp Hillerod, Dept Cardiol, Hillerod, Denmark
[6] Zealand Univ Hosp, Dept Cardiol, Roskilde, Denmark
[7] Odense Univ Hosp, Dept Infect Dis, Odense, Denmark
[8] Odense Univ Hosp, Dept Cardiol, Odense, Denmark
[9] Hvidovre Univ Hosp, Dept Infect Dis, Hvidovre, Denmark
[10] Hvidovre Univ Hosp, Dept Cardiol, Hvidovre, Denmark
[11] Copenhagen Univ Hosp, Rigshosp, Rigshospitalet, Copenhagen, Denmark
[12] Univ Hosp Copenhagen, Rigshosp, Dept Cardiol, Rigshospitalet, Copenhagen, Denmark
[13] Univ Copenhagen, Inst Clin Med, Copenhagen, Denmark
[14] Odense Univ Hosp, Dept Otorhinolaryngol, Odense, Denmark
[15] Aalborg Univ, Inst Clin Med, Aalborg, Denmark
[16] Aalborg Univ Hosp, Dept Infect Dis, Mollepk Vej 4, DK-9000 Aalborg, Denmark
关键词
brain abscess; cerebral abscess; hereditary haemorrhagic telangiectasia; HHT; PAVM; PFO; pulmonary arteriovenous malformation; shunt; CEREBRAL ABSCESSES;
D O I
10.1111/ene.16176
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and purposePulmonary arteriovenous malformations (PAVMs) may cause recurrent brain abscess. The primary aim was to determine the prevalence of PAVM amongst survivors of brain abscess. The proportion with cardiac right-to-left shunts was also assessed post hoc.MethodsThis was a cross-sectional population-based study of adult (>= 18 years) survivors of cryptogenic bacterial brain abscess in Denmark from 2007 through 2016. Patients were invited for bubble-echocardiography to detect vascular right-to-left shunting and, if abnormal, subsequent computed tomography thorax for diagnosis of PAVM. Data are presented as n/N (%) or median with interquartile range (IQR).ResultsStudy participation was accepted by 47/157 (30%) eligible patients amongst whom two did not appear for scheduled bubble-echocardiography. The median age of participants was 54 years (IQR 45-62) and 19/57 (33%) were females compared with 59 years (IQR 48-68, p = 0.05) and 41/85 females (48%, p = 0.22) in non-participants. Bubble-echocardiography was suggestive of shunt in 10/45 (22%) participants and PAVM was subsequently confirmed by computed tomography in one patient with grade 1 shunting. The corresponding prevalence of PAVM was 2% (95% confidence interval 0.06-11.8) amongst all examined participants. Another 9/45 (20%) were diagnosed with patent in persistent foramen ovale (n = 8) or atrial septum defect (n = 1), which is comparable with the overall prevalence of 25% amongst adults in the Danish background population.ConclusionsUndiagnosed PAVM amongst adult survivors of cryptogenic bacterial brain abscess is rare but may be considered in select patients. The prevalence of cardiac right-to-left shunts amongst brain abscess patients corresponds to the prevalence in the general population.
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