PMC7481736_01
MRI of the brain with and without Omniscan IV contrast showing a heterogeneous enhancing lesion within the right basal ganglia with associated edema and local mass effect.
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F1
On day 7 of hospitalization, the patient had a repeat MRI that demonstrated increased cerebral edema on the right side with the center of the mass demonstrating necrosis (see Fig. 1).
Non-necrotizing giant cells (arrow heads) surrounding fungal hyphae (black arrow). H and E stain.
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F2
On hospitalization day 11, with recommendation from neurosurgery, the patient received a right basal ganglia and deep white matter stereotactic brain biopsy, which demonstrated non-caseating granulomatous inflammation with giant cells (see Fig. 2).
GMS special stain shows fungal hyphae, favouring non-septate/pauciseptate hyphae.
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F3
On day 14, the full pathology report returned with Gomori methenamine-silver stain revealing the presence of fungal hyphae favoring non-septate/pauciseptate hyphae (see Fig. 3), which was consistent with an isolated cerebral mucormycosis infection.