Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Nov 25:3:9299.
doi: 10.1186/1752-1947-3-9299.

Brain abscesses in a patient with a patent foramen ovale: a case report

Fuad Jan  1 , Abdul Moiz Hafiz, Saurabh Gupta, John Meidl, Suhail Allaqaband
Affiliations

Brain abscesses in a patient with a patent foramen ovale: a case report

Fuad Jan et al. J Med Case Rep. .

Abstract

Introduction: Brain abscesses arising from right-to-left cardiac shunting are very rare in adults.

Case presentation: We describe the case of a 47-year-old non-hispanic white male with periodontal disease who developed several brain abscesses caused by Streptococcus intermedius. A comprehensive workup revealed a patent foramen ovale with oral flora as the only plausible explanation for the brain abscesses.

Conclusion: Based on this case and the relevant literature, we suggest an association between a silent patent foramen ovale, paradoxical microbial dissemination to the brain, and the development of brain abscesses.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Magnetic resonance imaging of the brain. (A) T1-weighted images at the patient's presentation, post-contrast showing multiple ring enhancing lesions in the brain (white arrow heads). (B) T1-weighted images eight months after treatment showing a resolution of the brain abscesses.
Figure 2
Figure 2
Transesophageal echocardiography during the patient's initial hospitalization. (A) A bidirectional interatrial shunt seen through the patent foramen ovale. RA, right atrium; LA, left atrium. (B) Injection of agitated saline through an upper extremity peripheral vein showing the appearance of bubbles crossing from the right to the left atrium. RA, right atrium; LA, left atrium.
See this image and copyright information in PMC

References

    1. Lechat P, Mas JL, Lescault G, Loron P, Theard M, Klimczac M, Drobinski G, Thomas D, Grosgogeat Y. Prevalence of patent foramen ovale in patients with a stroke. N Engl J Med. 1988;318:1148–1152. - PubMed
    1. Kundra SN. Patent foramen ovale as possible risk factor for cryptogenic brain abscess: report of two cases. Neurosurg. 2002;50:674–675. doi: 10.1097/00006123-200203000-00057. - DOI - PubMed
    1. Kawamata T, Takeshita M, Ishizuka N, Hori T. Patent foramen ovale as a possible risk factor for cryptogenic brain abscess: report of two cases. Neurosurg. 2001;49:204–207. doi: 10.1097/00006123-200107000-00032. - DOI - PubMed
    1. Khouzam RN, El-Dokla AM, Menkes DL. Undiagnosed patent foramen ovale presenting as a cryptogenic brain abscess: case report and review of the literature. Heart & Lung. 2006;35:108–111. doi: 10.1016/j.hrtlng.2005.07.007. - DOI - PubMed

LinkOut - more resources