Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas
Abstract Background Brain abscesses, a severe infectious disease of the CNS, are usually caused by a variety of different pathogens, which include Streptococcus intermedius (S. intermedius). Pulmonary arteriovenous fistulas (PAVFs), characterized by abnormal direct communication between pulmonary ar...
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12879-020-05092-6 |
| _version_ | 1828856071353008128 |
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| author | Lu-Yao Gao Guang-Run Xu Ting-Jun Dai |
| author_facet | Lu-Yao Gao Guang-Run Xu Ting-Jun Dai |
| author_sort | Lu-Yao Gao |
| collection | DOAJ |
| description | Abstract Background Brain abscesses, a severe infectious disease of the CNS, are usually caused by a variety of different pathogens, which include Streptococcus intermedius (S. intermedius). Pulmonary arteriovenous fistulas (PAVFs), characterized by abnormal direct communication between pulmonary artery and vein, are a rare underlying cause of brain abscesses. Case presentation The patient was a previous healthy 55-year-old man who presented with 5 days of headache and fever. Cerebral magnetic resonance imaging (MRI) suggested a brain abscess. Thoracic CT scan and angiography demonstrated PAVFs. Aiding by metagenomic next-generation sequencing (mNGS) of the cerebrospinal fluid (CSF) sample which identified S. intermedius as the causative pathogen, the patient was switched to the single therapy of large dose of penicillin G and was cured precisely and economically. Conclusions It is an alternative way to perform mNGS to identify causative pathogens in patients with brain abscesses especially when the results of traditional bacterial culture were negative. Further thoracic CT or pulmonary angiography should also be undertaken to rule out PAVFs as the potential cause of brain abscess if the patient without any known premorbid history. |
| first_indexed | 2024-12-13T01:08:04Z |
| format | Article |
| id | doaj.art-e3ccc4ca598040b780a7624697d66562 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-13T01:08:04Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-e3ccc4ca598040b780a7624697d665622022-12-22T00:04:32ZengBMCBMC Infectious Diseases1471-23342020-05-012011610.1186/s12879-020-05092-6Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulasLu-Yao Gao0Guang-Run Xu1Ting-Jun Dai2Department of Emergency Medicine and Chest Pain Center, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityDepartment of Neurology, Qilu Hospital of Shandong UniversityAbstract Background Brain abscesses, a severe infectious disease of the CNS, are usually caused by a variety of different pathogens, which include Streptococcus intermedius (S. intermedius). Pulmonary arteriovenous fistulas (PAVFs), characterized by abnormal direct communication between pulmonary artery and vein, are a rare underlying cause of brain abscesses. Case presentation The patient was a previous healthy 55-year-old man who presented with 5 days of headache and fever. Cerebral magnetic resonance imaging (MRI) suggested a brain abscess. Thoracic CT scan and angiography demonstrated PAVFs. Aiding by metagenomic next-generation sequencing (mNGS) of the cerebrospinal fluid (CSF) sample which identified S. intermedius as the causative pathogen, the patient was switched to the single therapy of large dose of penicillin G and was cured precisely and economically. Conclusions It is an alternative way to perform mNGS to identify causative pathogens in patients with brain abscesses especially when the results of traditional bacterial culture were negative. Further thoracic CT or pulmonary angiography should also be undertaken to rule out PAVFs as the potential cause of brain abscess if the patient without any known premorbid history.http://link.springer.com/article/10.1186/s12879-020-05092-6Brain abscessesPulmonary arteriovenous fistulasStreptococcus intermediusMetagenomic next-generation sequencing |
| spellingShingle | Lu-Yao Gao Guang-Run Xu Ting-Jun Dai Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas BMC Infectious Diseases Brain abscesses Pulmonary arteriovenous fistulas Streptococcus intermedius Metagenomic next-generation sequencing |
| title | Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas |
| title_full | Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas |
| title_fullStr | Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas |
| title_full_unstemmed | Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas |
| title_short | Precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas |
| title_sort | precision diagnosis and therapy of a case of brain abscesses associated with asymptomatic pulmonary arteriovenous fistulas |
| topic | Brain abscesses Pulmonary arteriovenous fistulas Streptococcus intermedius Metagenomic next-generation sequencing |
| url | http://link.springer.com/article/10.1186/s12879-020-05092-6 |
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