Cerebral abscess and thrombophilia in pregnancy. A case report.
BACKGROUND
Cerebral abscess in pregnancy is a rare event, with the etiology not well described. We present such a case in association with genetic thrombophilia.


METHODS
A 36-year-old primigravida with a prior history of bilateral popliteal vein thrombosis and pulmonary embolism presented in early gestation with right hemiparesis, aphasia, disseminated intravascular coagulation and a space-occupying lesion in the left temporal lobe. Stereotactic biopsy confirmed the presence of an abscess. The patient also had a homozygous methylene tetrahydrofolate reductase mutation (C677T), protein S deficiency and lupus anticoagulant, all of which possibly contributed to the thrombosis, infarct, infection and abscess. She was successfully treated with low-molecular-weight heparin and antibiotics and had a term vaginal delivery.


CONCLUSIONS
Recently genetic thrombophilia was reported in association with various complications of pregnancy, but it has never before been described as occurring with a cerebral abscess.
Baxi
L V
LV
Departments of Obstetrics and Gynecology, Neurology and Pathology, College of Physicians and Surgeons, Columbia University, Sloane Hospital for Women, New York Presbyterian Hospital, New York, New York, USA. lvbl@columbia.edu
Mayer
S A
SA
Mansukhani
M
M
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001922:Brain Abscess / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D042965:Methylenetetrahydrofolate Reductase (NADPH2); D000587:Oxidoreductases Acting on CH-NH Group Donors / Q000235:genetics; D017354:Point Mutation; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000209:etiology*; D011256:Pregnancy Outcome; D019851:Thrombophilia / Q000150:complications* / Q000235:genetics
D000900:Anti-Bacterial Agents; D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D000587:Oxidoreductases Acting on CH-NH Group Donors; D042965:Methylenetetrahydrofolate Reductase (NADPH2)