title: An unusual etiology of recurrent cerebral abscesses-a report of 3 cases.
abstract: BACKGROUND
  Cerebral abscess commonly occurs secondary to trauma, hematogenous spread from distant infection, or otitis media. Pulmonary AVF is an uncommon cause of recurrent cerebral abscess and is often overlooked. We report 3 cases of cerebral abscesses secondary to pulmonary AVF.
  
  
  METHODS
  A 20-year-old man who presented with fever, headache, and vomiting of short duration was diagnosed as having right parietal abscess and underwent burr hole and tapping and antibiotic treatment. He later presented with many episodes of cerebral abscess at various locations involving both sides and required multiple surgical procedures. The routine workup for the source did not reveal any etiology. His hematological examination revealed polycythemia. A pulmonary angiogram was performed, which revealed pulmonary AVF. He underwent embolization of the fistula and had no further recurrence. Two other adult men were treated surgically for cerebral abscess. One patient had polycythemia and hypoxemia, and another had clubbing. Both patients were investigated with CT of the chest and were diagnosed as having pulmonary AVF. None of them had features of HHT.
  
  
  CONCLUSIONS
  Pulmonary AVF is an unusual cause of cerebral abscess. Patients with multiple recurrences of cerebral abscess, signs of pulmonary disease, and hypoxia should be investigated for pulmonary AVF.
authors.affiliation: Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore 560029, India. arivazhagan.a@gmail.com
authors.forename: Arimappamagan
authors.initials: A
authors.lastname: Arivazhagan
authors.forename: Paritosh
authors.initials: P
authors.lastname: Pandey
authors.forename: B
authors.initials: B
authors.lastname: Anandh
authors.forename: Rojin G
authors.initials: RG
authors.lastname: Abraham
authors.forename: Devi B
authors.initials: DB
authors.lastname: Indira
authors.forename: S
authors.initials: S
authors.lastname: Sampath
authors.forename: B A
authors.initials: BA
authors.lastname: Chandramouli
authors.forename: Kiron
authors.initials: K
authors.lastname: Varghese
mesh_terms: D000328:Adult; D001164:Arteriovenous Fistula / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D001922:Brain Abscess / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000002:abnormalities*; D011667:Pulmonary Veins / Q000002:abnormalities*; D012008:Recurrence