Case Report

Unsuspected Polymicrobial Brain Abscess Arising from an Intra-Abdominal Source in a Patient with Hereditary Hemorrhagic Telangiectasia

Authors: Melina Diaz, MD, Jose Cuellar, MD, Paula A. Valencia-Rey, MD, John F. Fisher, MD

Abstract

The unusual and unprecedented occurrence of a patient with hereditary hemorrhagic telangiectasia (HHT) and a polymicrobial abscess with three different organisms, including fungi, is reported. The patient was a 48-year-old woman with human immunodeficiency virus (HIV) infection and HHT who was brought to the hospital after a motor vehicle accident with altered mental status. Computed tomography did not reveal evidence of acute brain injury but showed a left frontal brain abscess. The patient underwent neurosurgical drainage of the abscess. On culture the abscess yielded methicillin-resistant Staphylococcus aureus, Streptococcus intermedius, and Candida guilliermondii.

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