PMC9434960_01
(A,B) Axial and sagittal plane of the brain MRI on June 15 shows a right parietal-temporal lesion with huge perilesional edema, compression of the right lateral ventricle, and mediosagittal shift; (C,D) Contrast-enhanced ring lesions on the coronal and axial plane with perilesional edema. (E,F) Postoperative MRI on September 1 with postoperative sequela, abscess regression, and perifocal edema.
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F1
It showed a 4.6 x 4.3 x 3.9 cm multilocular lesion in the right frontoparietal region with a mass effect on the adjacent lateral ventricle (Figure 1).
Patohistology finding of the material obtained on surgery (A) Grocott methamine silver staining shows branching microfilamentous bacilli of Nocardia spp. (B) Hematoxylin-eosin staining (magnification 200x): necrotizing granulomas of different sizes with the presence of multi-nuclear Langhans giant cells.
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F2
Silver staining highlighted the filamentous branching rods (Figure 2).
Timeline of the clinical course. Timelines of hospital admissions, symptoms, events and SARS-CoV-2 testing are labeled from the initial positive RT-PCR test. The Novel Coronavirus (2019-nCoV) Nucleic Acid Diagnostic Kit (PCR-Fluorescence Probing) for the qualitative detection of the ORF1ab and N genes of SARS-CoV-2 RNA was used with Ct value <= 40 considered a positive result.
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F3
Over the next 5 weeks, the patient was tested for SARS-CoV2 seven times, and the result was always positive (Figure 3).