Cerebral abscess

Case contributed by Dr Ian Bickle

Presentation

Young overseas worker, with altered cognition.The patient was apyrexic and been 'off colour' for a couple of weeks.

Patient Data

Age: 30 years old
Gender: Male
MRI

Large thick walled ring enhancing right frontal lobe mass with avid internal diffusion restriction and marked perilesional oedema, with resultant effacement and displacement of the lateral ventricle.

Case Discussion

Cerebral abscess is one of a number of differential for a ring enhancing lesion in the brain.

The avid diffusion restriction makes an abscess highly likely, despite this patient had no fever or raised WCC. The immune response may be suppressed.

MR spectroscopy could have been performed to add further weight to the diagnosis.

Neurosurgery was performed. The final microbiological analysis identified the causative organism as Staphylococcus aureus.

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Case information

rID: 24212
Case created: 31st Jul 2013
Last edited: 27th Feb 2016
Inclusion in quiz mode: Included

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