Cerebral nocardiosis

Case contributed by Faeze Salahshour
Diagnosis certain

Presentation

Known case of CLL referred with seizures and hemiparesis.

Patient Data

Age: 75 years
Gender: Male
mri
This study is a stack
Axial
T1
This study is a stack
Axial
T2
This study is a stack
Axial
FLAIR
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Sagittal
T1 C+
This study is a stack
Axial
T1 C+
This study is a stack
Coronal
T1 C+
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Info

Several lesions with surrounding vasogenic oedema are seen in both the cerebral hemispheres. The lesions have a central cystic component without diffusion restriction, and a peripheral rind similar to a cheerio. The peripheral rind shows iso to mildly high T2 signal intensity, diffusion restriction, and linear enhancement of the inner margin.

Photograph
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Info

The CSF culture was positive for Nocardia.

Case Discussion

The patient underwent medical treatment with clinical improvement, on follow up CT, surrounding oedema, and the size of the lesions reduced. 

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