A 63-year old woman with no significant past medical history presents with 3-months of short-term memory difficulty, trouble concentrating, and emotional lability. She also has been noted by family to have intermittent bilateral jerking of her arms upon being startled. CMP, CBC, TSH, CRP, ESR, and B12 were all negative. RPR, ANA HIV, paraneoplastic antibody panel, urine drug screen, and serum HSV PCR were negative. Lumbar puncture was performed and lab results are pending. Brain MRI is shown below:
What is the name of the above MRI finding and likely diagnosis? Scroll down for the answer.
We had a wonderful ID-themed Journal Club with Dr. Tim Brown presenting the 2017 NEJM paper entitled “A Placebo-Controlled Trial of Antibiotics for Smaller Skin Abscesses,” a multicenter, prospective trial comparing the I&D alone vs. I&D with either clindamycin or TMP-SMX.
Thank you to our faculty discussants at each site: Dr. Cutrell at the VA, Dr. Frankie Lee at CUH, and Dr. Ank Nijhawan at Parkland!