Abstract
PREVIOUSLYHEALTHY22-YEAR-OLDMANWAS referredtoourinstitutionbyanotherhospitalbecauseofhighfever,drowsiness,and multiplering-enhancinglesionsonbrain computedtomography(CT).Medicalhistory was unremarkable, except for a tongue piercing the patienthadgotten2weeksearlier.Onhospitaladmission, globalaphasiaandrighthemiplegiawerefound.Histemperaturewas39°C,andhiswhitebloodcellcountshowed leukocytosis with a left shift. The patient was given empiricalantibiotictreatment.Magneticresonanceimaging of the brain revealed 13 ring enhancement lesions with surroundingedema,withfocalbleedinginsomeofthem (Figure). Results of an extensive clinical and laboratory workup, including abdominal CT, transesophageal echocardiography, immunoelectrophoresis, complement levels, antinuclear antibody test, human immunodeficiency virus test, and sweat test for cystic fibrosis, were negative, whilechestCTshowedlocalbronchiectasesontheleftlower lobe.Biopsyaspirationfromoneofthebrainlesionsrevealed
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
