Case 62

 A thirty nine-year-old male had been suffering from headache and smelly nasal fluids for approximately a week. He laid down all day the day before due to general fatigue and had no clear memory about the day before. The painful lesion was noted from left frontal head to left parietal head. The left swollen eye lid was found. Laboratory test revealed CRP 23.65 mg/dL, white blood cells 15650 / mm³ , neutrophils 83.2% and LDH 259 U/L.

 Para-nasal sinuses CT was first conducted (Fig.1). The following day, he felt weakness or almost paralysis of left lower extremity. Brain MRI was conducted for further examination (Figs. 2 and 3).

What is the appropriate imaging diagnosis ?

a. Frontal sinusitis

b. Brain abscess

c. Maxillary sinusitis

d. Subdural empyema

e. Subperiosteal abscess

1.a, b, c　　 2. b, c, d 　　 3. c, d, e 　　 4. all

answer

2017.7.12