case_images: PMC11055646_01
case_images: (a) Axial and (b) sagittal views of initial MRI imaging displayed left frontal, occipital, and parietal lobe abscesses with leptomeningeal enhancement.
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case_images: PMC11055646_01_CRIID2024-4728700.001.jpg
case_images: fig1
case_images: Initial workup including a computed tomography (CT) scan of the head and a magnetic resonance imaging (MRI) exam of the brain from a local community hospital showed multiple abscesses in the left frontal, occipital, and parietal lobes with leptomeningeal enhancement (Figures 1(a) and 1(b)).
case_images: The patient's initial CT scan of the chest, abdomen, and pelvis was remarkable for infarcts in the spleen and bilaterally in the kidneys.
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case_images: fig2
case_images: A CT chest/abdomen/pelvis demonstrated infarcts in the spleen and bilaterally in the kidneys (Figure 2).
case_images: (a) Transthoracic echocardiography (TTE) and (b) follow-up transesophageal study (TEE) demonstrating a density (identified by arrow in (b)) on the mitral valve.
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case_images: PMC11055646_01_CRIID2024-4728700.003.jpg
case_images: fig3
case_images: Transthoracic echocardiography (TTE) demonstrated a density on the mitral valve, and a follow-up transesophageal study (TEE) showed a 1.8 x 0.4 cm vegetation despite several sets of negative blood cultures (Figures 3(a) and 3(b)).
case_images: Repeat (a) axial and (b) sagittal views of MRI imaging after 12 weeks of antibiotic therapy demonstrated resolving left frontal, occipital, and parietal lobe abscesses.
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case_images: PMC11055646_01_CRIID2024-4728700.004.jpg
case_images: fig4
case_images: He underwent repeat MRI brain after 12 weeks of antibiotic therapy, which demonstrated resolving left frontal lobe intraparenchymal abscess (Figures 4(a) and 4(b)), and later CT angiography of the head after 16 weeks of therapy, which demonstrated resolved abscesses.