R. equi lesions in disseminated infection (case report 2). a Chest radiograph (May 2005) shows a non specific subpleural opacity in the right upper lobe without evidence of pleural effusion. b Contrast enhanced multidetector computed tomography (MDCT)(May 2005). A scan at the level of the main bronchi demonstrates a subpleural focal consolidation in the right upper lobe. There is no evidence of lymphoadenopathy or pleural effusion. c, d Contrast enhanced magnetic resonance imaging (MRI) of the right thigh (August 2009). The axial T2 sequence (c) and the axial T1 contrast enhanced sequence with fat suppression (ccGRE T1FS) (d) show an oval shaped enhancing mass in the vastus medialis muscle with central area of necrosis and oedema of the surrounding tissue and muscle. e Positron emission tomography (PET) and computed tomography (CT) images (August 2009) show focal increased fluodeoxyglucose (FDG) uptake in the upper lobe of the right lung and in the spleen, which is larger than normal, a large area of increased uptake in the right lower abdomen consistent with colon localization, and an irregular area of increased FDG uptake in the soft tissue of the right proximal thigh. f MDCT of the abdomen (March 2010). A scan through the lower abdomen shows a large obstructing mass in the right colon with stranding of the pericolonic fat and several enlarged lymph nodes. g Cutaneous nodular rhodococcal lesions (March 2010). h Brain axial T2 weighted sequence (August 2010) shows multiple (right temporal, left mesial occipital, left temporoinsular) expansive oedematous lesions. All the lesions show central hypointensity and peripheral hyperintensity. Oedema is also present in right occipital and anterior temporal lobes. i Brain axial T1 weighted sequence after Gd injection (August 2010) shows enhancement of the two nodular lesions in right temporal region and in left occipitomesial lobe. Smooth cortical enhancement is also seen in the left occipital lobe.
Ferretti et al. BMC Infectious Diseases 2011 11:343 doi:10.1186/1471-2334-11-343