Brain Abscess as the Initial Manifestation of Hereditary Hemorrhagic Telangiectasia in a Child.

BACKGROUND: Brain abscess secondary to pulmonary arteriovenous malformation is rare in children and may be the first manifestation of hereditary hemorrhagic telangiectasia (HHT). METHODS: We retrospectively reviewed the clinical presentation, laboratory findings, imaging examinations, and diagnostic process of a child with brain abscess associated with pulmonary arteriovenous malformation and HHT. RESULTS: A 12-year-old boy presented with fever, headache, and limb weakness. Brain abscess was diagnosed, and antimicrobial therapy was initiated. Laboratory testing revealed fungal infection and erythrocytosis. Further evaluation identified a pulmonary arteriovenous malformation. Although the family history was initially unremarkable, physical examination revealed facial telangiectasia, recurrent epistaxis, and digital clubbing in his father, fulfilling the Curaçao criteria for HHT. CONCLUSIONS: Right-to-left shunt should be considered in children with brain abscess of unclear origin. Early recognition of underlying HHT is critical for timely diagnosis and management.