Case Notes
History
57 yo male who sustained cut on leg 3 weeks earlier and now presents with systemic and neurologic symptoms; blood cultured revealed MRSA sepsis.Exam
MR T2-w turbo spin-echo
Prior Study
MR flair1. Multicentric sites of septic embolism, as listed above, located in both the cerebrum and cerebellum. The lesions vary in age from initial phase cerebritis to late phase brain abscess. There is no evidence of leptomeningitis.
MR T1-w post contrast
1. All the sites of septic emboli enhance. The interconnection of the daughter abscesses is clearly evident on this enhanced exam.
2. There is evidence of sequestered post infectious tissue necrosis mainly in the left parieto-occipital area.
MR diffusion
1. Five of the septic embolic infectious sites represent mature abscesses with positive MR diffusion. The other exhibit only T2-w shine-through of edema.