case_images: PMC8320724_01
case_images: MRI findings of CM in our patients. (A) Abnormally enlarged perivascular spaces in the basal ganglia bilaterally (white arrows) in Axial T2-weighted images (WI); (B) Choroid plexus (white arrows) at the admission in Axial gadolinium-enhanced T1-WI; (C) Bilateral choroid plexitis (white arrows) after ten days of antifungal therapy, in Axial gadolinium-enhanced T1-WI. (D) Absence of choroid plexitis after steroids therapy in Axial enhanced T1-WI.
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case_images: PMC8320724_01_fimmu-12-708837-g001.jpg
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case_images: Brain magnetic resonance imaging (MRI) did not exhibit lesions or evidence suggestive of high intracranial pressure, except for enlarged perivascular spaces in the basal ganglia ( Figure 1 ). To support the inflammatory hypothesis, as reported by Hammoud et al., brain MRI performed at this stage was conducted which demonstrated hypertrophic choroid plexus (choroid plexitis) ( Figure 1 ). The brain MRI performed at the end of steroid therapy also exhibited resolution of previously reported abnormalities ( Figure 1 ). The patient was then discharged from the hospital after two weeks from the initiation of steroids therapy, with resolution of diplopia with no other neurological deficits.
case_images: Graphical representation of CM therapy in our patient.
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case_images: He continued trimethoprim/sulfamethoxazole prophylaxis (160/800 mg daily, three times a week) plus maintenance fluconazole (800 mg) and continuation of weekly administration of SC immunoglobulin infusions ( Figure 2 ).