Brain abscess following endoscopic injection sclerotherapy: report of a case.
A 33-year-old male patient with hepatitis B surface antigen positive cirrhosis, received 2 courses of endoscopic injection sclerotherapy for bleeding esophageal varices. A Streptococcus viridans brain abscess developed 2 weeks after the first sclerotherapy (or 1 week after the second sclerotherapy). In cirrhotic patients, an increase in pulmonary vasodilatation and pulmonary arteriovenous shunting has been well recognized. Sclerosant as well as bacteria may pass through a pulmonary arteriovenous shunt and reach the brain, directly after an infection of esophageal varices. Brain ischemia and a bacterial infection may occur at the same time, this can accelerate the development of a pyogenic brain abscess. Careful observation for the early detection and treatment of infection following endoscopic sclerotherapy is essential.
Tai
D I
DI
Department of Gastroenterology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan, R.O.C.
Lan
C K
CK
Hen
H J
HJ
D000328:Adult; D001922:Brain Abscess / Q000209:etiology*; D004724:Endoscopy; D006801:Humans; D008297:Male; D015911:Sclerotherapy / Q000009:adverse effects*