Upon initial evaluation bacterial meningitis was confirmed. MRI of the brain with contrast administration was requested and showed mild swelling of the right frontal cortex compared to the other side which was better appreciated on T2WI, with meningeal thickening and enhancement of this region as well. Paranasal sinusitis was also seen indicating intracranial extension of infection.

Brain MRI one month later was done due to further clinical deterioration of the patient unfortunately demonstrating the above findings.