Presentation
Dizziness.
Patient Data
Incomplete ring enhancing lesion with vasogenic edema and mild mass effect in the left parietal lobe.
Hypodense lesions in the right basal ganglia and right cerebellar hemisphere.
Cortical calcification in the right poscentral gyrus.
Multiple T2/FLAIR-hyperintense, contrast-enhancing lesions in the left parietal lobe, left occipital lobe, left hippocampus, right caudate, and both cerebellar hemispheres.
"Eccentric target sign" in left hippocampus and cerebellar lesions.
No restriction on DWI/ADC. Low rCBV values. High lipid peak and reduced Cho, Cr and NAA on MRS. Findings are suggestive of non-pyogenic brain abscesses or metastatic disease.
Eccentric target sign is suggestive of toxoplasmosis.
Case Discussion
Serology:
- HIV +
- Toxoplasma IgG +
CD4 < 100.
Anti-toxoplasma therapy was initiated with the resolution of the findings.
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