EURORAD ESR

Case 13381

Cat-scratch disease encephalitis

Author(s)
Prat-Matifoll J.A, Barber Martinez de la Torre I, Delgado I, Ángel Sánchez-Montañez García-Carpintero, Elida Vázquez

Vall Hebron Hospital,
Institut Català de la Salut,
Radiology;
Passeig Vall Hebrón 116-119
08035 Barcelona, Spain;
Email:joanalbertpratrx@gmail.com
 
Patient
male, 8 year(s)
 
 
  • Figure 1
    Emergency brain CT

    Unenhanced brain CT showed no relevant abnormality.

     
    Area of Interest: Head and neck; Imaging Technique: CT; Procedure: Education; Special Focus: Acute;
     
     
  • Figure 2
    Intensive care - Inguinal sonography

    Sonography revealed a hypoechoic rounded lesion (yellow arrows) with a vascular hilum (blue arrow), with an adjacent subcutaneous collection (red arrows), consistent with supurative inflamatory lymphadenopathy.

     
    Area of Interest: Liver; Imaging Technique: Ultrasound-Colour Doppler; Procedure: Abscess delineation; Special Focus: Abscess;
     
     
  • Figure 3
    Intesive care - Abdominal sonography

    Using the convex transducer probe subtle small hypoecoic lesions were identified (yellow arrows).

     
    Area of Interest: Spleen; Imaging Technique: Ultrasound; Procedure: Abscess delineation; Special Focus: Abscess;
     
     
  • Figure 4
    Intensive care - Abdominal sonography

    After changing to a high-frequency linear probe, multiple hypoechoic liver and splenic lesions became more conspicuous (yellow arrows), consistent with hepato-splenic granulomata or micro-abscesses.

     
    Area of Interest: Spleen; Imaging Technique: Ultrasound; Procedure: Localisation; Special Focus: Infection;
     
     
  • Figure 5
    Brain MRI

    Axial DWI images of the brain showing scattered cortical altered diffusion (blue arrows), probably related to cerebral vasogenic oedema.

     
    Area of Interest: Head and neck; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Imaging sequences; Special Focus: Acute;
     
     
  • Figure 6
    Liver MRI

    Liver MRI confirmed the presence of multiple T2-hyperintense lesions showing restricted diffusion (red arrows) compatible with granulomata or micro-abscesses.

     
    Area of Interest: Liver; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Abscess delineation; Special Focus: Acute;
     
     
  • Figure 7
    Abdominal sonography 1 week after the acute onset

    One week after the acute onset of CSD encephalitis, abdominal sonography was performed. The hypoechoic lesions have increased in size, possibly related to post-treatment changes.

     
    Area of Interest: Abdomen; Imaging Technique: Ultrasound; Procedure: Abscess delineation; Special Focus: Acute;
     
     
Unenhanced brain CT showed no relevant abnormality.
 
Sonography revealed a hypoechoic rounded lesion (yellow arrows) with a vascular hilum (blue arrow), with an adjacent subcutaneous collection (red arrows), consistent with supurative inflamatory lymphadenopathy.
 
Using the convex transducer probe subtle small hypoecoic lesions were identified (yellow arrows).
 
After changing to a high-frequency linear probe, multiple hypoechoic liver and splenic lesions became more conspicuous (yellow arrows), consistent with hepato-splenic granulomata or micro-abscesses.
 
Axial DWI images of the brain showing scattered cortical altered diffusion (blue arrows), probably related to cerebral vasogenic oedema.
 
Liver MRI confirmed the presence of multiple T2-hyperintense lesions showing restricted diffusion (red arrows) compatible with granulomata or micro-abscesses.
 
One week after the acute onset of CSD encephalitis, abdominal sonography was performed. The hypoechoic lesions have increased in size, possibly related to post-treatment changes.
 
 
 
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