A 34-year-old woman presented with progressive headache of 3 months' duration but was otherwise in good health with no abnormal neurological signs. The chest radiograph was unremarkable. Brain magnetic resonance imaging showed a well-defined ring-enhancing lesion in the left occipital region with perifocal edema. The capsule was hypointense with intracavitary projections seen arising from the wall on T2-weighted axial images. These projections were hyperintense on diffusion-weighted images with an apparent diffusion coefficient value of 0.51 × 10−3 mm2/s (Figure 1). A preoperative diagnosis of fungal abscess was subsequently confirmed after surgery and on histologic findings. A Gomori methenamine silver stain revealed round bodies of Histoplasma capsulatum in foamy histiocytes (Figure 2). She was treated with antifungal drugs and was without any symptoms at 6 months' follow-up.
Anit Parihar, Vaishali Tomar, Bal K. Ojha, Nuzhat Husain, Rakesh K. Gupta. Magnetic Resonance Imaging Findings in a Patient With Isolated Histoplasma Brain Abscess. Arch Neurol. 2011;68(4):534–535. doi:10.1001/archneurol.2011.59