title: [A brain abscess as a complication of hepatopulmonary syndrome coexisting with interstitial pneumonia].
abstract: A 76-year-old woman with a 20-year history of chronic hepatitis C was referred to our hospital for worsening exertional dyspnea. She had been given a diagnosis of interstitial pneumonia based on chest computed tomography findings 5 years previously. Contrast-enhanced echocardiography confirmed an intrapulmonary right-to-left shunt, and therefore we diagnosed hepatopulmonary syndrome comorbid with interstitial pneumonia. In July 2009 she was admitted to our hospital with a low grade fever, headache, and vomiting. We diagnosed a left cerebellar brain abscess caused by Streptococcus intermedius. She underwent stereotactic burr-hole drainage and received vancomycin, piperacillin and cefotaxime. Cases of brain abscess secondary to hepatopulmonary syndrome are rare. Nevertheless, we should be aware of this complication of hepatopulmonary syndrome.
authors.affiliation: Nippon Steel Yawata Memorial Hospital.
authors.forename: Toyoshi
authors.initials: T
authors.lastname: Yanagihara
authors.forename: Atsushi
authors.initials: A
authors.lastname: Moriwaki
authors.forename: Nanae
authors.initials: N
authors.lastname: Seki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Akata
authors.forename: Tomotoshi
authors.initials: T
authors.lastname: Imanaga
mesh_terms: D000368:Aged; D001922:Brain Abscess / Q000209:etiology*; D005260:Female; D020065:Hepatopulmonary Syndrome / Q000150:complications*; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000150:complications*; D013290:Streptococcal Infections / Q000150:complications*; D034367:Streptococcus intermedius