PMC4038640_01
CT Chest with contrast: There are numerous bilateral pulmonary nodules of varying sizes, ranging from under a millimeter to 2.5 cm in the superior segment of the left lower lobe. The more peripheral lesions are larger in size and demonstrate early central cavitation.
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A CT chest/abdomen/pelvis was done, which revealed multiple bilateral pulmonary nodules with signs of early cavitation (Figure 1).
(A, B) CT angio head/neck: There is focal aneurysmal dilatation of the left vertebral artery at the C4 level; this may be secondary to infectious changes. No definite dissection is seen at this level.
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CT angiogram of the head/neck revealed focal aneurysmal dilatation of the left vertebral artery at the C4 level, likely representing a mycotic aneurysm; prevertebral phlegmonous changes with nonocclusive thrombus in the left internal jugular vein; and thrombus extending from left transverse sinus to left sigmoid dural venous sinus (Figure 2). Cervical thoracic lumbosacral spine imaging revealed a large circumferential epidural collection at C3-C6 level with near complete effacement of the thecal sac and left ventrolateral epidural abscess extending from T5-T7 level measuring 8x14x31 mm with no evidence of spinal cord compression.