Adult brain abscess associated with patent foramen ovale: a case report

Abstract

Brain abscess results from local or metastatic septic spread to the brain. The primary infectious site is often undetected, more commonly so when it is distant. Unlike pediatric congenital heart disease, minor intracardiac right-to-left shunting due to patent foramen ovale has not been appreciated as a cause of brain abscess in adults. Here we present a case of brain abscess associated with a patent foramen ovale in a 53-year old man with dental-gingival sepsis treated in the intensive care unit. Based on this case and the relevant literature we suggest a link between a silent patent foramen ovale, paradoxic pathogen dissemination to the brain, and development of brain abscess.

Brain abscess associated with patent foramen ovale

“…To our knowledge, there have been 19 cases of brain abscess associated with PFO reported in the literature, including our own [1,4,9,11,16,19,21,23,25,33,35] (Table 2). These reports each include one or two cases, and this study is the first series report of brain abscess with PFO.…”

Patent Foramen Ovale as a Risk Factor for Cryptogenic Brain Abscess: Case Report and Review of the Literature

“…There are 12 cases in the literature which have described an association of PFO and brain abscess in adults (Table 1) (4,(8)(9)(10)(11)(12)(13)(14)(15). Most of the patients were middle-aged with no significant medical history.…”

Patent Foramen Ovale in Elderly: A Cadaveric Case Report

“…25 Recently and with increasing frequency, paradoxically septic embolism through a PFO has been correlated with brain abscesses and transcatheter PFO closure has been suggested as prevention for recurrent brain abscesses. 26 In most cases ASDs are diagnosed and treated successfully with few or no complications. Early diagnosis and treatment can help to prevent complication.…”