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Intracranial Micrococcus Luteus Infection Mimicking Brain Metastases on 18 F-FDG PET/CT
Qiaoqiao Shu1, Maoxue Deng, Liang Cai
1Department of Nuclear Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Abstract:
An 86-year-old man presented with slurred speech and right lower limb shaking for 1 month. Initial brain MRI revealed an abnormal signal lesion in the left parietal lobe with peripheral parenchymal edema, and brain metastases were suspected. Subsequent PET/CT showed increased focal FDG uptake in the left parietal lobe, accompanied by bands of surrounding brain parenchyma edema. No other abnormal lesions were observed on 18 F-FDG PET/CT except for increased inflammatory lymph node activity in the left hilar region. Finally, the cerebrospinal fluid puncture culture showed a Micrococcus luteus infection. Therefore, the clinical diagnosis was infectious lesions.
Insights
A rare Micrococcus luteus infection mimicked brain metastases in an elderly patient. Prompt cerebrospinal fluid analysis confirmed the infection, leading to the correct diagnosis of infectious lesions.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Brain lesions presenting with neurological symptoms like slurred speech and limb shaking can be challenging to diagnose.
- Differentiating between neoplastic and infectious etiologies is critical for appropriate patient management.
Purpose of the Study:
- To report a case of Micrococcus luteus infection mimicking brain metastases in an elderly male.
- To highlight the importance of considering infectious causes in focal brain lesions with surrounding edema.
Main Methods:
- A case study of an 86-year-old man with new-onset neurological deficits.
- Initial evaluation included Magnetic Resonance Imaging (MRI) and Positron Emission Tomography/Computed Tomography (PET/CT).
- Diagnosis was confirmed via cerebrospinal fluid (CSF) culture.
Main Results:
- Brain MRI revealed a left parietal lobe lesion with edema, initially suspicious for metastasis.
- 18F-FDG PET/CT showed increased uptake in the lesion and surrounding edema, without other metastatic signs.
- CSF culture identified Micrococcus luteus.
Conclusions:
- Focal brain lesions with edema can be caused by rare bacterial infections.
- Micrococcus luteus should be considered in the differential diagnosis of central nervous system infections.
- Infectious etiology was confirmed, necessitating targeted antibiotic therapy.
