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Crescentic "Semilunar" Cap-Like Pus-Fluid Level in Bacterial-Fungal Brain Abscess

Nazmin Ahmed1, Mohammad Nazrul Hossain1, Bipin Chaurasia2

  • 1Department of Neurosurgery Ibrahim Cardiac Hospital & Research Institute Dhaka Bangladesh.

Clinical Case Reports
|June 30, 2026
PubMed

Insights

A crescent-shaped fluid level in brain abscesses, identified on CT/MRI, can help doctors recognize this serious infection before surgery. This finding is especially useful when combined with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) data.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Brain abscesses are serious infections requiring prompt diagnosis and treatment.
  • Polymicrobial infections, involving both bacteria and fungi, present diagnostic challenges.
  • Accurate preoperative recognition is crucial for effective surgical planning and patient outcomes.

Purpose of the Study:

  • To identify a specific imaging finding suggestive of polymicrobial brain abscess.
  • To evaluate the utility of a crescentic pus-fluid level on CT/MRI for preoperative diagnosis.
  • To correlate imaging findings with clinical context and advanced MRI techniques.

Main Methods:

  • Retrospective analysis of CT and MRI scans in patients with brain abscess.
  • Identification and characterization of a crescentic (semilunar) pus-fluid level.
  • Correlation of imaging findings with microbiological data and clinical presentation.
  • Utilized diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping.

Main Results:

  • A distinct crescentic pus-fluid level was observed in polymicrobial brain abscesses.
  • This finding was visible across various CT and MRI sequences.
  • The presence of this level aided in differentiating abscess types when considered with clinical context and DWI/ADC data.

Conclusions:

  • The crescentic pus-fluid level is a potentially valuable sign for the preoperative recognition of polymicrobial brain abscesses.
  • Integrating this imaging feature with clinical information and DWI/ADC enhances diagnostic accuracy.
  • This aids in optimizing surgical and therapeutic strategies for brain abscesses.
Keywords:
bacterial‐fungalbrain abscesscrescentic (semilunar) cappus–fluid level

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