title: An emboligenic pulmonary abscess leading to ischemic stroke and secondary brain abscess.
abstract: BACKGROUND
  Ischemic stroke by septic embolism occurs primarily in the context of infective endocarditis or in patients with a right-to-left shunt and formation of a secondary cerebral abscess is a rare event. Erosion of pulmonary veins by a pulmonary abscess can lead to transcardiac septic embolism but to our knowledge no case of septic embolic ischemic stroke from a pulmonary abscess with secondary transformation into a brain abscess has been reported to date.
  
  
  METHODS
  We report the case of a patient with a pulmonary abscess causing a septic embolic cerebral infarction which then transformed into a cerebral abscess. After antibiotic therapy and drainage of the abscess the patient could be rehabilitated and presented an impressive improvement of symptoms.
  
  
  CONCLUSIONS
  Septic embolism should be considered as cause of ischemic stroke in patients with pulmonary abscess and can be followed by formation of a secondary cerebral abscess. Early antibiotic treatment and repeated cranial CT-scans for detection of a secondary abscess should be performed.
authors.affiliation: Department of Neurology, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany. phil.albrecht@gmail.com
authors.forename: Philipp
authors.initials: P
authors.lastname: Albrecht
authors.forename: Mark
authors.initials: M
authors.lastname: Stettner
authors.forename: Leila
authors.initials: L
authors.lastname: Husseini
authors.forename: Stephan
authors.initials: S
authors.lastname: Macht
authors.forename: Sebastian
authors.initials: S
authors.lastname: Jander
authors.forename: Colin
authors.initials: C
authors.lastname: Mackenzie
authors.forename: Ulrike
authors.initials: U
authors.lastname: Oesterlee
authors.forename: Philipp
authors.initials: P
authors.lastname: Slotty
authors.forename: Axel
authors.initials: A
authors.lastname: Methner
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Hartung
authors.forename: Orhan
authors.initials: O
authors.lastname: Aktas
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001922:Brain Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D003937:Diagnosis, Differential; D045825:Fusobacteriaceae Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008169:Lung Abscess / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents