PMC5664263_01
MRI brain taken on hospital day 3. (a) FLAIR enhancement of the ventricles and fluid levels within the posterior lateral ventricles, consistent with ventriculitis. (b) T2 enhanced images showing acute infarcts in the periventricular areas (arrows).
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FLAIR enhancement showed enhancement of the ventricles and pooling of purulent material into the posterior lateral ventricles, consistent with ventriculitis (Figure 1). T2 enhancement showed acute infarcts in the periventricular areas, likely from septic emboli (Figure 1).
MRI of the lumbar spine on hospital day 3. This MRI shows a fluid collection within the left psoas muscle. The collection was aspirated and revealed purulent brown material, consistent with an abscess.
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Spine imaging showed a fluid collection in the left psoas muscle (Figure 2).
Ultrasound of the right eye. Ultrasound of the right eye shows a thickened retina and debris within the vitreous humor. These findings are consistent with inflammation and purulent material within the eye.
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Ophthalmological ultrasound revealed a thickened retina and debris within the vitreous fluid (Figure 3).
Repeat MRI of the brain on hospital day 10. (a) There is much less FLAIR enhancement of the ventricles, consistent with improving infection. (b) T2 weighted images showing several new infarcts within the bilateral thalami, basal ganglia, and right parietal lobe (arrows). Also visible are older, evolving infarcts.
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FLAIR enhancement showed improvement in the ventriculitis (Figure 4); T2 enhancement showed additional infarcts now within the bilateral thalami, basal ganglia, and right parietal lobe (Figure 4).
Repeat MRI of the lumbar spine on hospital day 10. Visible here is a persistent fluid collection within the left psoas muscle that has increased in size from previous MRI (Figure 2) despite CT guided aspiration.
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Lumbar spine showed an increase in size of the fluid collection within the psoas muscle (Figure 5).