Unusual synchronous liver and brain abscesses infected by rare Aerococcus viridians in a patient with pulmonary arteriovenous malformations on FDG PET/CT: A case report and literature review

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Rationale:Pulmonary arteriovenous malformations (PAVMs) complicated with multiple organ abscesses is an uncommon manifestation. Because of the low incidence of the disease, F-18 fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) imaging studies for PAVMs complicated with multiple organ abscesses are scarce.Patient concerns:We report a case of a 54-year-old man presenting with PAVMs complicated with synchronous multiple organ abscesses founded by 18F-FDG PET/CT. 18F-FDG PET/CT revealed tortuous stripes and mass opacities with no significant FDG uptake in the left upper lung lobe. However, hypermetabolic lesions located in the anterior inferior segment of right hepatic lobe [with maximum standardized uptake value (SUVmax) of 10.7], and in the right basal ganglia with SUVmax of 14.1 were found by 18F-FDG PET/CT.Diagnoses:A diagnosis of synchronous liver and brain abscesses infected by rare Aerococcus viridans was determined by tissue culture.Interventions:Vancomycin was provided intravenously, and oral linezolidate tablets were prescribed for anti-inflammatory treatment for 1 month. Liver and head magnetic resonance imaging was performed during the follow-up.Outcomes:The lesion in the right basal ganglia was reduced, and the lesion in the right liver had disappeared, indicating the lesions were abscesses.Lessons:The present case indicated that the possibility of abscesses should be considered with patients with PAVMs, and whole-body 18F-FDG PET/CT is suggested to identify possible accompanying abscesses in multiple organs for PAVMs patients.

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