Brain abscess results from local or metastatic septic spread to the brain. Approximately, 15-60% of brain abscesses are considered to be cryptogenetic, being the primary infectious site often undetected. Patent foramen ovale (PFO) has been suggested as a potential source of paradoxical embolism; this was suggested after detecting a higher prevalence of PFO in ischemic stroke of unexplained cause. Brain abscess may develop as a consequence of paradoxical infectious emboli from an extracranial infective source. We present the case of a patient with no history of intravenous drug use and no periodontal disease, which was found to have a brain abscess, tricuspid valve endocarditis and the presence of a PFO with right to left shunting with no other source of infection.
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