Infectious meningitis mimicking recurrent medulloblastoma on magnetic resonance imaging. Case report.
This report and the accompanying review of the literature address the challenges, when using surveillance magnetic resonance (MR) imaging, of establishing the origin of newly detected central nervous system lesions. Routine surveillance MR imaging in a 16-year-old boy, whose medulloblastoma had been successfully treated, demonstrated asymptomatic nodular leptomeningeal enhancement of the brain and spinal cord, which was consistent with recurrent disease. Examination of the cerebrospinal fluid, however, led to the diagnosis of bacterial meningitis. Two weeks after completion of antibiotic therapy, the original MR imaging findings were seen to have resolved. This case illustrates the importance of considering clinical and laboratory data, including results from a complete examination of the cerebrospinal fluid, when interpreting the origin of new lesions revealed by MR imaging.
Fouladi
M
M
Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
Heideman
R
R
Langston
J W
JW
Kun
L E
LE
Thompson
S J
SJ
Gajjar
A
A
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis; D002528:Cerebellar Neoplasms / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000175:diagnosis*; D016920:Meningitis, Bacterial / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis; D013203:Staphylococcal Infections / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy; D013212:Staphylococcus epidermidis; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin