Enunciado Male patient, 20 years old, previously healthy, presented with cough, fever (not measured) and inappetence (loss of 10 kg) for 20 days. Confusion, drowsiness and gait alteration ("pulling the right leg") 4 days ago. Physical examination: oral thrush, altered level of consciousness and focal neurologic deficit, with reduced mobility of the right inferior member. A magnetic resonance of the brain was performed. Image 1: Magnetic resonance of the brain, axial view, at the level of the frontal lobes, T1-weighted, before the intravenous contrast injection (A); and T1-weighted, after the intravenous contrast injection (B). Image 2: Magnetic resonance of the brain, at the level of the basal ganglia, T2-weighted (A) and FLAIR (B). Question:Based on the clinical history and the images, what is the most likely diagnosis? Neurotoxoplasmosis Primary CNS lymphoma Progressive multifocal leukoencephalopathy Neurocryptococcosis Questão de Prova (2014 Medical Residency Examination – Universidade Federal Fluminense) Hypodense lesion with ring enhancement after the intravenous contrast injection is an nonspecific finding at the computed tomography that can correspond to many etiologic agents of inflammatory-infectious processes. In the immunocompromised patient, especially the HIV+, the most common etiologic agent in Brazil is: Tuberculosis Blastomycosis Aspergillosis Thrush Toxoplasmosis Time is Up! Time's up
