Multiple brain abscesses as a complication of pulmonary arteriovenous fistula. A case report.

A case of pulmonary arteriovenous fistula (PAVF) complicated by brain abscess is presented. The incidence of this complication has been quoted to be 1-5%. After reviewing all inpatients in Chang Gung Memorial Hospital from 1977 to 1988, we found a total of 9 cases of PAVF; only one case of PAVF complicated by brain abscess was noted. PAVF is often asymptomatic in the early stage, and its diagnosis may sometimes be quite difficult. However, untreated PAVF tends to enlarge and become symptomatic. There is also a continuing risk of severe neurologic complications. For these reasons, early diagnosis and treatment are essential. In a case of brain abscess associated with unexplained hypoxemia and extra-cardiac murmur on auscultation, PAVF should be considered.