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Brain lesions as heralding manifestations of systemic disease can pose a diagnostic problem, particularly when other organ system involvement is not apparent and neuroimaging is nonspecific. Computerized tomography (CT) may identify additional lesion sites. However, when chest roentgenogram (x-ray) is negative chest CT is not routinely considered. A patient is presented in whom chests CT led to lung biopsy and diagnosis of cerebral cryptococcoma when clinical and neuroimaging features were nonspecific and chest x-ray and serology were negative. We suggest that chest CT is warranted in patients with abnormal brain imaging not typical of a primary brain process, even in the presence of a negative chest x-ray. |
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abscess,intracerebral
abscess,intracranial-fungal
abscess,lung
CAT scan,chest
central nervous system,infection of
cerebrospinal fluid,oligoclonal IgG in
chest x-ray
cryptococcoma,cerebral
cryptococcosis
fungal infection
fungal infection,CNS
lung biopsy
misdiagnosis
MRI,abnormal
negative
neurologic disease,diagnoses of
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