PMC3616049_01
MRI revealed right basilar meningeal enhancement concerning for meningitis and acute infarction of the right basil ganglia.
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MRI of the brain and Neurologic consult where obtained. MRI with and without contrast revealed right basilar meningeal enhancement with an acute right basil ganglia infarction (Figures 1,2).
CT Thorax findings consist of right upper lobe cluster of nodules with central cavitations.
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CSF where negative for acid fast bacilli, and PCR of the CSF was negative for TB on two different occasions. CT of the chest was obtained to look for possible source of infection and revealed right upper lobe nodules with central cavitations (Figures 3,4).
CT guided biopsy right lung nodule reveals acid fast bacilli (arrows).
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Biopsy of the lung was performed and pathology revealed necrotizing granulomatous inflammation with acid fast bacilli (Figures 5,6).