A Case Report of Impaired Aggregation of Platelets in Hereditary Hemorrhagic Telangiectasia Associated with Brain Abscess

Abstract

A 14 year-old girl was admitted because of low grade fever and frequent seizure attacks. Brain CT yielded a diagnosis of brain abscess and tapping aspirations were carried out. No pathogen was isolated from culture. The chest X-ray showed nodular shadows on bilateral lung fields. Pulmonary angiography identified the feeding arteries and draining veins with multiple minute fistulae. Hereditary hemorrhagic telangiectasia was diagnosed based on oral cavity telangiectasia, and a family history of nasal bleeding. Laboratory tests of blood coagulation showed normal bleeding time, and coagulation factors, but decreased aggregation of platelets. Brain abscess in hereditary hemorrhagic telangiectasia with pulmonary arteriovenous fistula is a rare complication, but should be considered in cases with neurologic manifestations.