Cerebral abscess and thrombophilia in pregnancy. A case report.

J Reprod Med

Departments of Obstetrics and Gynecology, Neurology and Pathology, College of Physicians and Surgeons, Columbia University, Sloane Hospital for Women, New York Presbyterian Hospital, New York, New York, USA.

Published: June 2001

Background: Cerebral abscess in pregnancy is a rare event, with the etiology not well described. We present such a case in association with genetic thrombophilia.

Case: A 36-year-old primigravida with a prior history of bilateral popliteal vein thrombosis and pulmonary embolism presented in early gestation with right hemiparesis, aphasia, disseminated intravascular coagulation and a space-occupying lesion in the left temporal lobe. Stereotactic biopsy confirmed the presence of an abscess. The patient also had a homozygous methylene tetrahydrofolate reductase mutation (C677T), protein S deficiency and lupus anticoagulant, all of which possibly contributed to the thrombosis, infarct, infection and abscess. She was successfully treated with low-molecular-weight heparin and antibiotics and had a term vaginal delivery.

Conclusion: Recently genetic thrombophilia was reported in association with various complications of pregnancy, but it has never before been described as occurring with a cerebral abscess.

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