Silent Persistent Left Superior Vena Cava Right-to-Left Shunt as a Unique Cause of Recurrent Brain Abscesses

Wepresent a rare case of a young man who developed 2 brain abscesses during his life, one at age 6 and the other at age 39. Investigation as to the cause of such a rare reoccurrence revealed a silent but abnormal flow of blood in his body that allowed bacteria to reach the brain more easily. His brain infection was treated surgically and with antibiotics, and once he was stable, the route of abnormal blood flow was corrected through surgery. We present a novel case of recurrent brain abscesses found to be the result of a silent congenital right-to-left extracardiac shunt, a persistent left superior vena cava draining into the left atrium. The patient's brain abscess was evacuated surgically and treated with antibiotics, and his shunt was subsequently repaired. The case suggests that attention should be paid to evaluation for shunt physiology allowing for bypass of the pulmonary circulation in those with recurrent brain abscesses.

Automated summary

This article presents a rare case of a young man who experienced 2 brain abscesses at different ages. Investigation revealed an abnormal blood flow that facilitated bacterial reach to the brain. The patient received surgical and antibiotic treatments for the brain infection and correction of the abnormal blood flow.