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Related Concept Videos

Bacterial Meningitis01:24

Bacterial Meningitis

Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
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Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
Bacterial Meningitis II: Pathophysiology01:26

Bacterial Meningitis II: Pathophysiology

Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
Brain Abscess l: Introduction01:26

Brain Abscess l: Introduction

A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...
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Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...

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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
Summary

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.

Keywords:
bacterial‐fungalbrain abscesscrescentic (semilunar) cappus–fluid level

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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.