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case_images: MRI of the right lower extremities showed thick fluid collection with heterogeneous signal intensities (complex collection) in subtalar joint and signal changes in most hind foot bones and some midfoot. There was narrowing of the tibiotalar joint space and destruction of the tibial subchondral bone (at the tibia talar dome), talus bone, and the fibular lateral malleolus. Tibial, fibular, talus, and mild calcaneus bone marrow edema surrounding the tibial lesions was seen with edematous infiltration of the per malleolar soft tissues with skin discontinuation suggesting an ulcer. There was diffuse marrow infiltration in the distal tibial (epiphysial-metaphyseal region), talus and distal epiphysis of fibula.. MRI: magnetic resonance imaging.
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case_images: Magnetic resonance imaging (MRI) of the ankle was done which showed narrowing of the tibiotalar joint space, with thick fluid collection and destruction of the cartilage tibial subchondral bone (at the tibial talar dome), talus bone and the fibular lateral malleolus (Figure 1(a) and (b)).
case_images: Yellowish cheese-like discharge seen after debridement of the ankle ulcer.
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case_images: The fluid discharge from the ankle was described as a yellowish cheese-like material.(Figure 2).
case_images: MRI brain showing few punctate focal lesions involving the cerebral hemispheres, brainstem, and cerebellum. The lesions were isointense on T1 and had high signals on T2/FLAIR. There was a lesion in the right cerebellum showing low T2/FLAIR intensity center with peripheral hyperintensity and mild surrounding edema which showed ring enhancement after contrast administration (white arrow). There was no significant mass effect.. MRI: magnetic resonance imaging.
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case_images: An MRI of the brain during her admission to the ICU was done and showed ring-enhancing lesions (Figure 3).
case_images: Non-contrast brain CT showing effacement of cerebral sulci and basal cisterns consistent with brain edema. There was leptomeningeal enhancement marked in the right occipital lobe and the cerebellum.. CT: computed tomography.
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case_images: ATT during which time her fever subsided and her mental status improved. A brain computed tomography (CT) scan done before discharge revealed features suggestive of meningitis, which was attributed to TB (Figure 4).
case_images: Brain MRI revealed dilatation of the ventricular system with widening of the temporal horns, due to communicating hydrocephalus. Post-contrast images demonstrated thick nodular leptomeningeal enhancement predominantly in the basal cisterns.. MRI: magnetic resonance imaging.
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case_images: Brain MRI showed features of meningitis with communicating hydrocephalus (Figure 5).
case_images: Brain MRI revealing left caudate hematoma, ventriculomegaly, prominent cerebrospinal fluid (CSF) at the fourth ventricle extending inferiorly to posterior of foramen magnum. There were multifocal intracranial hypodense lesions with associated multifocal calcifications:most likely neurocysticercosis.. MRI: magnetic resonance imaging.
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case_images: Brain MRI also revealed features suggestive of neurocysticercosis (Figure 6).
case_images: CT-pulmonary angiography revealed pulmonary embolism with dilated right atrium and mild contrast backflow to inferior venacava (IVC), consistent with signs of pulmonary hypertension.. CT: computed tomography.
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case_images: She later developed an acute onset of dyspnea, which was confirmed to be due to pulmonary embolism by CT-pulmonary angiography (Figure 7).