A 28-year-old woman, who had been subjected to a dental procedure two weeks before, consulted for seizures and fever. At oral cavity examination, palatine telangiectasias were evidenced, with no signs of dental infection. The chest X-ray showed a well-defined pulmonary opacity in the inferior right lobe (Fig. 1A) and a cerebral contrast CT scan evidenced a ring-enhancement lesion in the right parietal lobe suggesting a cerebral abscess (Fig. 1B). A thoracic CT scan was performed showing a 7mm pulmonary arterio-venous malformation (AVM) in the right inferior lobe (Fig. 1C). A contrast transesophageal echocardiogram confirmed a grade 3 right-to-left shunt (Fig. 1D, RA: right atrium; LA: left atrium; SVC: superior vena cava; IAS: interatrial septum). The cerebral abscess was drained and antibiotic treatment was completed (positive hemocultures for streptococcus sp). Endovascular embolotherapy of the pulmonary AVM was performed. The final diagnosis was Rendu-Osler-Weber disease.

Figure 1

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