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Case No. 325
2013-12-02~2013-12-31
출제자 : 안성수
Hit : 458
| Period | 2013-12-02~2013-12-31 |
|---|---|
| Diagnosis | HIV encephalitis with cryptococcal infection |
| Clinical information | 39/M CC: mental change 진단은? |
| Discussion | 정답: HIV encephalitis with cryptococcal infection 해설: MRI shows generalized atrophy of the brain. T2WI demonstrates diffuse, symmetric hyperintensities in the bilateral periventricular WM. Multiple small cystic lesions are also seen in the bilateral basal ganglia and thalami, which may be gelatinous pseudocysts. The lesions does not enhance after contrast injection. Opportunistic fungal infection that typically affects immunocompromised patients, especially those with HIV Cryptococci spread along perivascular spaces to deep brain: basal ganglia, thalamus, midbrain, dentate nuclei, and subcortical white matter 4 imaging patterns: military enhancing parenchymal nodules, leptomeningeal-cisternal nodules, cryptococcoma, gelatinous pseudocysts MRI: “Soap bubbles” of multiple dilated perivascular spaces in deep gray matter, which are hypointense on T1WI and hyperintense on T2WI, typically no enhancement |
| Correct answer |
Correct Answer
Semi-Correct Answer |