Neuro-Behcet Disease Mistakenly Diagnosed as a Brain Abscess Because of a Ring Contrast Enhanced Lesion on Brain MRI
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A 27-year-old man was hospitalized for an evaluation of a high fever and left hemiparesis. Gadolinium-enhanced MRI disclosed a lesion with ring enhanced areas with marked edema extending from the right basal ganglia and thalamus to the midbrain that appeared to be a brain abscess. The lesion resolved almost completely during the 2 month period after admission. Three weeks after discharge the patient again developed a high fever, and an MRI examination disclosed a large new lesion involving the left thalamus, brainstem and upper pons. No ring enhancement was detected by gadolinium-enhanced MRI, and the new lesion again spontaneously resolved almost completely, but during the second admission the patient also developed oral aphthae and skin eruptions suggesting Behcet's disease. This is a rare case suggesting that the lesions occurring in association with neuro-Behcet disease may resolve spontaneously.