PMC3869474_01
An MRI of the brain, T2 W images, axial (A) and coronal view (B). Clearly visible in the right portion of the pons is a hyperintense area (white arrows), according to pathologic findings (mucormycosis localisation).
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figure1
On day 17, the patient developed areflexia, paresis, slurred speech, and lateral lingual swelling; a brain computed tomography (CT) scan was negative; brain magnetic resonance images (MRIs) showed an alterated signal in T2 sequences on the pontobulbar zone (Figure 1a,b).
A mycotic thrombus occluding the lumen of the basilar artery (A) (2x original magnification, Grocott staining). The fungi showed typical broad, haphazardly branched hyphae that performed a basilary artery wall, inset (B) (40x original magnification, Grocott staining).
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All these features are pathognomonic of Mucor spp. infection (Figure 2a,b).
The cerebral parenchyma showed red neurons typically observed in early ischaemic damage (20x original magnification HE staining).
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The brain parenchyma showed an early ischaemic damage (red neurons) in the presence of to complete neuronal loss areas, microglial activation, oedema, and vascular engulfment (Figure 3).