10 year old male boy presented with history of severe Headache, High grade fever n anorexia for last 15 days. CNS examination reveals no gross abnormalities. WBC.. 27900 LFT, RFT normal ESR 78 CRP 101 HIV NON REACTIVE X RAY CHEST:- NAD DISPLAYED CECT BRAIN IMAGES BELOW. KINDLY PROVIDE YOUR DIAGNOSIS N FURTHER MANAGEMENT . REGARDS.

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CT : Ring enhancing lesion with central clearance on right side..... ABCESS Clinically : Young age, fever > 2 weeks , severe headache, anorexia, Leukocytosis, ESR -very high, CRP raised.....? TUBERCULOSIS Provisional diagnosis : Tubercular Brain Abcess (Right). DD : Pyogenic brain abcess (less likely) Further investigation needed : CSF Analysis with Gram and ZN staining.

SOL seen in right parietal region Most likely an abscess(Pyogenic v/s Tubercular) Suggest: CT guided aspiration/surgical drainage Send specimen for c/s Specimen for Gram and ZN stain Inj.Ceftriaxone Inj.Vancomycin Inj.Metro CXR 2-D Echo LFTs HIV HBsAg HCV Routine labs

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Hallo dr. Ct shows round shape imeage its cystocercosis. Start tab. Albendazol 400 mg stat then 200 mg od for 21 days. Repeat ct after one month. Inj. Ceftriaxone 2gm stat then 1 gm 12 hrly. Inj. Mannitol 50 ml tds. Sos csf examination for routin, microscopy, cow wabes, z.n. stain. Iv fluids inj. Ondensetron 4mg ivly 8 hrly. Inj. Ranitedine 50 mg 12 hrly. Neuro physician openion.

Continuation.Suggest cardiac evaluation .Start Ceftriaxone with Ampicillin+vancomycin + metrogyl.careful Csf study

Rt CEREBRAL Abscess , Need MR SPECTRO to know the etiology , Echo cardiography, CxR, Blood C/S , & ENT evaluation r must to find out the primary lesion (if any)

Abscess rt tempòroparietal area with walled.

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Space occupying lesion ....R/o infective endocarditis ...Do blood culture and CSF analysis ...Culture sensitivity

Brain abscess Adv. CSF examination including culture Blood culture.

sol neurocystericosis tuberculoma are DDS

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