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Pulmonary arteriovenous malformations in patients with previous brain abscess: a cross-sectional population-based study.
Bodilsen, Jacob; Madsen, Trine; Brandt, Christian Thomas; Müllertz, Katrine; Wiese, Lothar; Demirci, Semra Turan; Suhrs, Hannah Elena; Larsen, Lykke; Gill, Sabine Ute Alice; Hansen, Birgitte Rønde; Nilsson, Brian; Omland, Lars Haukali; Fosbøl, Emil; Kjeldsen, Anette Drøhse; Nielsen, Henrik.
Afiliación
  • Bodilsen J; Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
  • Madsen T; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
  • Brandt CT; Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark.
  • Müllertz K; Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark.
  • Wiese L; Department of Cardiology, Nordsjaellands Hospital Hillerød, Hillerød, Denmark.
  • Demirci ST; Department of Infectious Diseases, Zealand University Hospital, Roskilde, Denmark.
  • Suhrs HE; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
  • Larsen L; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.
  • Gill SUA; Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
  • Hansen BR; Department of Cardiology, Odense University Hospital, Odense, Denmark.
  • Nilsson B; Department of Infectious Diseases, Hvidovre University Hospital, Hvidovre, Denmark.
  • Omland LH; Department of Cardiology, Hvidovre University Hospital, Hvidovre, Denmark.
  • Fosbøl E; Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
  • Kjeldsen AD; Department of Cardiology, Heart Centre, University Hospital of Copenhagen, Rigshospitalet, Copenhagen, Denmark.
  • Nielsen H; Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Eur J Neurol ; 31(4): e16176, 2024 Apr.
Article en En | MEDLINE | ID: mdl-38064178
BACKGROUND AND PURPOSE: Pulmonary 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. METHODS: This 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). RESULTS: Study 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. CONCLUSIONS: Undiagnosed 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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Malformaciones Arteriovenosas / Arteria Pulmonar / Venas Pulmonares / Telangiectasia Hemorrágica Hereditaria / Absceso Encefálico / Fístula Arteriovenosa Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Malformaciones Arteriovenosas / Arteria Pulmonar / Venas Pulmonares / Telangiectasia Hemorrágica Hereditaria / Absceso Encefálico / Fístula Arteriovenosa Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Eur J Neurol Asunto de la revista: NEUROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Dinamarca Pais de publicación: Reino Unido