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ABSTRACT: A 52-year-old man was admitted with a brain abscess in the left basal ganglia. He had a paradoxical brain embolic mechanism owing to a pulmonary arteriovenous fistula (PAVF) and was diagnosed as having a right-to-left shunt by transesophageal echocardiography (TEE) and transcranial color Doppler (TCD) with saline contrast medium. We determined that the brain abscess was caused by the PAVFs without Rendu-Osler-Weber disease. TEE and TCD with saline contrast medium were very useful for identifying the presence of the right-to-left shunt that caused the brain abscess.
Internal Medicine 02/2009; 48(6):485-7. · 0.94 Impact Factor