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CASE REPORT
Year : 2021  |  Volume : 8  |  Issue : 6  |  Page : 302-305

Persistent left superior vena cava presenting as brain abscess: A case report


1 Department of Pediatrics, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India
2 Department of Radiology, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India

Correspondence Address:
Dr. Bhakti U Sarangi
Department of Pediatrics, Bharati Vidyapeeth Medical College and Hospital, Pune - 411 043, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpcc.jpcc_75_21

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A persistent left superior vena cava (PLSVC) draining into the left atrial appendage can exist as an unidentified right-to-left shunt often with no demonstrable evidence of hypoxia on history but predisposing to life-threatening clinical implications. We present a 7-year-old boy with a brain abscess who was incidentally noted to have features of hypoxia on examination. His evaluation revealed the presence of a PLSVC on computed tomography pulmonary angiogram, draining into the left atrium, thereby acting as a right-to-left shunt explaining the brain abscess. He underwent a craniotomy with a course of intravenous antibiotics, remained well on follow-up, and was referred for definitive surgery for PLSVC. Children with unidentified right-to-left shunts may present with brain abscesses in the event of which both intracardiac and extracardiac shunts have to be ruled out with the help of history, a focused clinical assessment, and more advanced imaging.


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