J Neurocrit Care.  2021 Dec;14(2):123-124. 10.18700/jnc.210026.

Serial brain magnetic resonance imaging in a patient with invasive streptococcal infection with ventriculitis and choroid plexitis

• Chung J
• Lee JY
• Kim YS

• KMID: 2523725
• DOI: http://doi.org/10.18700/jnc.210026

Figure

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  Fig. 1. Serial brain magnetic resonance imaging (MRI) findings of invasive streptococcal sepsis with ventriculitis and choroid plexitis. Initial brain images reveal hydrocephalus with severe interstitial edema and non-suppressed high-signal fluid in the lateral ventricle on fluid-attenuated inversion recovery (FLAIR) imaging, suggesting pyogenic ventriculitis. In addition, restricted diffusion on diffusion-weighted imaging (DWI) and low signal intensity on susceptibility-weighted imaging (SWI) in both choroid plexuses indicate choroid plexitis with hemorrhaging (A). Although the patient’s mental status improved after administration of intravenous vancomycin and ceftriaxone, no significant change is observed in the brain MRI on day 7 after admission (B). The brain MRI of day 45 shows improved hydrocephalus, interstitial edema, ventriculitis, and choroid plexitis; however, a high signal of cerebrospinal fluid on FLAIR imaging is noted (C). Finally, on day 300, a normal brain MRI is observed (D).

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