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Article in Japanese
Abstract
Case Report
A brain abscess as a complication of hepatopulmonary syndrome coexisting with interstitial pneumonia
Toyoshi Yanagihara Atsushi Moriwaki Nanae Seki Kentaro Akata Tomotoshi Imanaga
Division of Respiratory Disease, Nippon Steel Yawata Memorial Hospital
ABSTRACT
A 76-year-old woman with a 20-year history of chronic hepatitis C was referred to our hospital for worsening exertional dyspnea. She had been given a diagnosis of interstitial pneumonia based on chest computed tomography findings 5 years previously. Contrast-enhanced echocardiography confirmed an intrapulmonary right-to-left shunt, and therefore we diagnosed hepatopulmonary syndrome comorbid with interstitial pneumonia. In July 2009 she was admitted to our hospital with a low grade fever, headache, and vomiting. We diagnosed a left cerebellar brain abscess caused by Streptococcus intermedius. She underwent stereotactic burr-hole drainage and received vancomycin, piperacillin and cefotaxime. Cases of brain abscess secondary to hepatopulmonary syndrome are rare. Nevertheless, we should be aware of this complication of hepatopulmonary syndrome.
KEYWORDS
Hepatopulmonary syndrome Liver cirrhosis Brain abscess Contrast enhanced echocardiography Streptococcus intermedius
Received 平成22年12月10日
JJRS, 49(7): 534-537, 2011
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