case_images: PMC10701533_01
case_images: Brain MRI images of patient 1. In the right frontal lobe, a mass-like lesion with peripheral edema presenting long T1 and T2 signals was observed (A, B). Axial, coronal, and sagittal contrast enhanced-T1 weighted images showing a lesion with heterogeneous ring-enhancement (C-E). Repeat brain MRI images showing that the lesion disappeared 1 month later (F).
case_images: fnins-17-1248493-g001.jpg
case_images: PMC10701533_02_fnins-17-1248493-g001.jpg
case_images: fig1
case_images: A timeline showing the relevant diagnosis and treatment data is shown in Supplementary Figure S1.
case_images: The white-yellow, viscous pus was extracted for pathogen identification (A) Images of the bacteria culture of the pus showing that creamy white, moist, and confluent colonies were observed on chocolate agar in an anaerobic medium. (B) Gram staining of the extracted bacteria colonies showing gram-negative filamentous rods (10 x 100 magnification). (C) Pathological examination of the removed capsule wall tissue in patient 1 showing the presence of inflammation, accompanied with the infiltration of neutrophils (scale bar = 200 mum) (D).
case_images: fnins-17-1248493-g002.jpg
case_images: PMC10701533_01_fnins-17-1248493-g002.jpg
case_images: fig2
case_images: During operation, a white-yellow, viscous pus was aspirated for microbial culture (Figure 2A) and the capsule wall was removed for pathological examination and mNGS testing. The pathological results for the removed tissue indicated the presence of inflammation, accompanied with the infiltration of neutrophils, confirming an abscess (Figure 2D). As shown in Figure 2B, creamy white, moist, and confluent colonies were observed on chocolate agar in an anaerobic medium; additionally, the gram staining of extracted bacteria colonies showed the presence of gram-negative filamentous rods (Figure 2C).
case_images: PMC10701533_02
case_images: Brain MRI images of patient 1. In the right frontal lobe, a mass-like lesion with peripheral edema presenting long T1 and T2 signals was observed (A, B). Axial, coronal, and sagittal contrast enhanced-T1 weighted images showing a lesion with heterogeneous ring-enhancement (C-E). Repeat brain MRI images showing that the lesion disappeared 1 month later (F).
case_images: fnins-17-1248493-g001.jpg
case_images: PMC10701533_02_fnins-17-1248493-g001.jpg
case_images: fig1
case_images: A timeline showing the relevant diagnosis and treatment data is shown in Supplementary Figure S1.
case_images: Brain MRI images of patient 2. In the left frontal lobe, a mass-like lesion with peripheral edema presenting long T1 and T2 signals was observed (A, B). A high intensity DWI signal and a low intensity ADC signal of the lesion were present (C, D). Axial, coronal, and sagittal contrast enhanced-T1 weighted images showing a typical ring-enhanced lesion (E-G). Repeat brain MRI images showing that the lesion disappeared 1 month later (H).
case_images: fnins-17-1248493-g003.jpg
case_images: PMC10701533_02_fnins-17-1248493-g003.jpg
case_images: fig3
case_images: A cranial MRI showed a cystic space-occupying lesion sized 28 x 43 mm with long T1 and T2 signals in the left frontal lobe (Figures 3A,B). High intensely diffusion weighted imaging (DWI) signals and decreased apparent diffusion coefficient (ADC) signals were also manifested (Figures 3C,D). Heterogeneous ring-enhancement and peripheral edema were also revealed in contrast enhanced T1 imaging (Figures 3E-G); additionally, a compressed left ventricle, middle-line shift, and mass effect were observed. This patient had normal muscle strength and was generally in good condition when discharged; repeat brain MRI imaging showed that the lesion had disappeared after 1 month (Figure 3H).
case_images: Brain MRS imaging of patient 2 showing an elevated Cho/NAA ratio and amount of lipid in the lesion area (A). Dark-red, viscous pus was aspirated and collected for pathogen identification (B).
case_images: fnins-17-1248493-g004.jpg
case_images: PMC10701533_02_fnins-17-1248493-g004.jpg
case_images: fig4
case_images: Cho/NAA ratio and amount of lipid in the lesion area compared with the normal region (Figure 4A). Combining these imaging features and her medical history, a brain abscess was highly suspected. During operation, a copious amount of dark-red, viscous pus was aspirated and collected for microbial culture and mNGS testing (Figure 4B).