Headache and Fever in a Renal Transplant Recipient: What If Multiple Brain Lesions Appear on MRI?
Nocardia asteroides Brain Abscess: MRI and CT Findings, Differential Diagnosis, Treatment, and Prognosis A new headache and fever in a renal transplant recipient may initially appear to represent an ordinary infectious illness. However, when neurological symptoms such as confusion, speech disturbance, or focal weakness develop and brain MRI demonstrates multiple enhancing lesions, the diagnostic perspective must change immediately. In an immunosuppressed patient, multiple enhancing brain lesions are not simply a radiologic finding—they are a clinical warning signal. The combination of renal transplantation, long-term immunosuppression, fever, headache, neurological deterioration, and multiple bilateral cerebral lesions should raise serious consideration of central nervous system (CNS) nocardiosis , particularly when the imaging pattern suggests multiple abscesses. This case illustrates an important principle of modern radiology: The diagnosis is not contained in the MRI image alo...