case_images: PMC4427073_01
case_images: Multifocal T2 magnetic resonance image showing high signal intensity noted in parasagittal left frontoparietal region; there is intense punctuate enhancement post-gadolinium contrast (white arrows).
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case_images: A magnetic resonance image of the brain was done concluding multifocal enhancing foci suggestive of an infective process (Figure 1).
case_images: MDCT Helical axial cut of the pelvis showing the prostate is enlarged with a faint ring enhancing lesion measuring 3x2.7x3 cm (white arrow).. Note: The lesion takes up most of the right side of the prostate, extending to the right seminal vesicles.. Abbreviation: MDCT, multiple detector computed tomography.
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case_images: Light microscopy examination of the needle core prostatic biopsy showing multiple necrotizing granulomata with giant cells (white arrow), high suspicion of infective etiology; in particular mycobacterium bacteria.
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case_images: The biopsy showed multiple slides of necrotizing granulomata suggestive of tuberculosis (Figure 3).
case_images: Ziehl-Neelsen histochemical stain prepared on the paraffin block tissue showed positive staining of rare occasional acid-fast bacilli (white arrow) within the epithelioid granulomata and necrotic debris, confirming mycobacterium bacteria.
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case_images: Ziehl-Neelsen stain was also performed, and the diagnosis of miliary tuberculosis was confirmed (Figure 4).