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Cerebellar abscess

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

Increasing ataxia and headaches. Febrile illness 1 week prior.

Patient Data

Age: 3 years
Gender: Male

MRI brain

mri

Selected images from an MRI of the brain demonstrates a large peripherally enhancing mass in the right cerebellar hemisphere. It demonstrates prominent central restricted diffusion. It is surrounded by edema and results in mass effect and compression of the 4th ventricle. A moderate degree of hydrocephalus is present (note the transependymal edema). 

Case Discussion

This patient went on to have a craniotomy and aspiration of the content of the lesion.

Gram stain: ++++ Gram positive cocci in chains and pairs, confirmed to be Strep pneumoniae. 

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