PMC3363139_01
(A) Computed tomography scan at admission showing a brain mass with edema of the peripheral white matter in the left parietal lobe. (B) Brain MRI T2-flair revealed a mass in the left parietal lobe measuring approximately 23 mm x 17 mm, with irregular central necrosis and edema of the peripheral white matter. (C) Brain computed tomography scan obtained two days after admission showing a mass in the left parietal lobe, approximately 32 mm x 22 mm, with central cystic change, ring-like enhancement, and edema of the peripheral white matter.
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Cranial computed tomography (CT) showed a brain mass with edema of the peripheral white matter in the left parietal lobe (Figure 1A). Magnetic resonance imaging of the brain revealed a mass in the left parietal lobe with irregular central necrosis and edema of the peripheral white matter (Figure 1B). A subsequent cranial CT scan showed that the brain mass had increased in size, with ring-like enhancement and more severe edema of the peripheral white matter (Figure 1C).
(A) hematoxylin and eosin stain showing necrotic tissue with neutrophilic infiltration (original magnification x 400). (B) Ziehl-Neelsen stain demonstrating acid-fast bacilli (original magnification x 400).
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The pathology report showed predominantly neutrophils with necrotic tissue and no caseation or granuloma tissue, which was compatible with a brain abscess (Figure 2A). Ziehl-Neelsen staining of the pus revealed that acid-fast bacilli were present (Figure 2B).