PMC6374803_01
(a) CT head with contrast showing a 3 cm region of heterogeneous low density in the right frontal lobe. A second, 1.5 to 2 cm region of low attenuation in the anterior aspect of the left basal ganglia consistent with an intraaxial mass lesion compressing the left lateral ventricle. (b) MRI brain with contrast showing a central cavitary, contrast-enhancing lesion involving the lateral left cerebellar hemisphere (see arrow).
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fig1
Neuroimaging showed centrally cavitary, peripherally enhancing intra-axial brain lesions, involving the right frontal lobe, the left basal ganglia, and the lateral aspect of the left cerebellar hemisphere (Figure 1).
(a) Right frontal lobe histopathology (low power) showing dense lymphocytic infiltrate with granuloma formation. Abundant mononuclear cells are present. AFB and fungal stains were negative. (b) Hematoxylin and eosin stain, with arrows demonstrating amoebic trophozoites under high power magnification (x100).
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fig2
The final histopathology was consistent with granulomatous amebic encephalitis (Figure 2).