When Do Ring-Enhancing Brain Lesions Need to Be Biopsied, and Should They Be Treated Empirically First?
  • Nadia Khosrodad
    Department of Internal Medicine, St. Joseph Mercy Oakland Hospital, Pontiac, MI, USA
  • Justin Khine
    Clinical Teaching Fellow, Ross University, Miramar, FL, USA
  • Jeffrey Maclean
    Department of Radiology, St. Joseph Mercy Oakland Hospital, Pontiac, MI, USA
  • Fnu Abhishek
    Department of Neurology, St. Joseph Mercy Oakland Hospital, Pontiac, MI, USA

Keywords

Neuroimaging, abscess, immunocompromised, toxoplasmosis, PCNSL, idiopathic CD4 leukocytopenia

Abstract

Other than acute cerebrovascular accidents, multiple ring-enhancing lesions are among the most common lesions encountered in neuroimaging. We herein describe the case of a 63-year-old diabetic man presenting with altered mental status, hyperglycaemia and community-acquired pneumonia who was found to have two ring-enhancing lesions involving the left frontal lobe and left basal ganglia. The lesions were biopsied to reveal positive fungal cultures and toxoplasma cysts. RPR titres returned reactive for non-treponemal antibodies and a suppressed CD4 count was found without evidence of HIV infection.

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    Published: 2019-04-10
    Issue: Vol 6 No 4 (view)

    How to cite:
    1.
    Khosrodad N, Khine J, Maclean J, Abhishek F. When Do Ring-Enhancing Brain Lesions Need to Be Biopsied, and Should They Be Treated Empirically First?. EJCRIM 2019;6 doi:10.12890/2019_001068.