Pyogenic brain abscess with atypical features resembling glioblastoma in advanced MRI imaging

Differentiation between infectious and neoplastic brain processes is crucial for treatment planning. Advanced magnetic resonance imaging techniques, such as diffusion, perfusion, susceptibility weighted imaging, and magnetic resonance spectroscopy, enhance the imaging differences between these two pathologies. However, despite the utilization of these advanced techniques, the pathologic process may be confound by atypical findings. Here, we report a case of an autistic patient with multiple brain lesions with diffusion weighted imaging, susceptibility weighted imaging, and perfusion patterns resembling features of a multicentric glioblastoma, which were confirmed surgically, neuropathologically, and bacteriologically as brain abscesses. We discuss the differentiation of these different entities in the light of advanced magnetic resonance imaging techniques.