Case report
An emboligenic pulmonary abscess leading to ischemic stroke and secondary brain abscess
1 Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
2 Department of Diagnostic and Interventional Radiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
3 Department of Medical Microbiology and Hospital Hygiene, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
4 Department of Cardiology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
5 Department of Neurosurgery, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
BMC Neurology 2012, 12:133 doi:10.1186/1471-2377-12-133
Published: 5 November 2012Abstract
Background
Ischemic stroke by septic embolism occurs primarily in the context of infective endocarditis or in patients with a right-to-left shunt and formation of a secondary cerebral abscess is a rare event. Erosion of pulmonary veins by a pulmonary abscess can lead to transcardiac septic embolism but to our knowledge no case of septic embolic ischemic stroke from a pulmonary abscess with secondary transformation into a brain abscess has been reported to date.
Case presentation
We report the case of a patient with a pulmonary abscess causing a septic embolic cerebral infarction which then transformed into a cerebral abscess. After antibiotic therapy and drainage of the abscess the patient could be rehabilitated and presented an impressive improvement of symptoms.
Conclusion
Septic embolism should be considered as cause of ischemic stroke in patients with pulmonary abscess and can be followed by formation of a secondary cerebral abscess. Early antibiotic treatment and repeated cranial CT-scans for detection of a secondary abscess should be performed.
