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Prevalence of hereditary hemorrhagic telangiectasia in patients operated for cerebral abscess: a retrospective cohort analysis

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Abstract

It is well described that patients with pulmonary arteriovenous malformations (PAVMs) and Hereditary Hemorrhagic Telangiectasia (HHT) have an increased risk of cerebral abscess (CA). However, as both CA and HHT are rare, the proportion of patients with CA who are diagnosed with HHT has not been previously described. A retrospective study was carried out of all patients treated surgically for CA between January 1995 and September 2014 at the Department of Neurosurgery, Odense University Hospital. The cases were then cross-referenced with the Danish HHT database. Eighty patients aged 5–79 years were included. The incidence of CA was 0.33/100,000/year. Two patients (2.5%) were registered as having HHT. Bacterial pathogens were identified in 70% of all cases, most frequently streptococci species (46.3%). The most common predisposing condition was odontogenic infection (20%), followed by post-operative infection (13.8%) and post-trauma (6.3%). Patients undergoing a full diagnostic program to determine predisposing conditions causing CA increased over the 20-year period from 11.8% to 65.2%. The 3-month and 1-year mortality rates were 7.5% and 11.25%, respectively. There is an overrepresentation of HHT patients in a cohort of patients with CA, and HHT should be investigated as the cause of the CA if no other apparent cause can be identified.

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Acknowledgments

Contributors CRM, ADK, and FRP were involved in the study design. ADK and FRP sampled the patients and CRM performed the statistical analyses. All authors were involved in the interpretation of the results. LL and CRM wrote the manuscript, and all authors commented on and approved the final manuscript.

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Authors and Affiliations

  1. Department of Infectious Diseases, Odense University Hospital, J. B. Winsloews Vej 4, Indgang 18, Penthouse 2. sal, 5000, Odense, Denmark

    L. Larsen

  2. Department of Neurosurgery, Odense University Hospital, 5000, Odense, Denmark

    C. R. Marker & F. R. Poulsen

  3. Danish Hereditary Hemorrhagic Telangiectasia Center, Department of Otorhinolaryngology, Odense University Hospital, 5000, Odense, Denmark

    C. R. Marker & A. D. Kjeldsen

  4. Clinical Institute, University of Southern Denmark, 5230, Odense, Denmark

    L. Larsen, A. D. Kjeldsen & F. R. Poulsen

Authors
  1. L. Larsen
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  2. C. R. Marker
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  3. A. D. Kjeldsen
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  4. F. R. Poulsen
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Corresponding author

Correspondence to L. Larsen.

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No funding was given to this study.

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None declared.

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Larsen, L., Marker, C.R., Kjeldsen, A.D. et al. Prevalence of hereditary hemorrhagic telangiectasia in patients operated for cerebral abscess: a retrospective cohort analysis. Eur J Clin Microbiol Infect Dis 36, 1975–1980 (2017). https://doi.org/10.1007/s10096-017-3023-7

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  • DOI: https://doi.org/10.1007/s10096-017-3023-7

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