%0 Journal Article
%T Pulmonary arteriovenous malformations in patients with previous brain abscess: a cross-sectional population-based study.
%A Bodilsen J
%A Madsen T
%A Brandt CT
%A Müllertz K
%A Wiese L
%A Demirci ST
%A Suhrs HE
%A Larsen L
%A Gill SUA
%A Hansen BR
%A Nilsson B
%A Omland LH
%A Fosbøl E
%A Kjeldsen AD
%A Nielsen H
%A  
%J Eur J Neurol
%V 31
%N 4
%D 2024 Apr 8
%M 38064178
%F 6.288
%R 10.1111/ene.16176
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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).<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.