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. Author manuscript; available in PMC: 2016 Sep 20.
Published in final edited form as: Ann Neurol. 2015 Aug 24;78(5):722–730. doi: 10.1002/ana.24499

Figure 1. Neuroimaging and Neuropathology.

Figure 1

A, Axial T2-weighted / fluid attenuated inversion recovery (FLAIR) brain magnetic resonance imaging (MRI) demonstrating multiple hyperintensities (arrows) which correspond to areas of restricted diffusion on diffusion weighted imaging (not shown). B, Axial T2-weighted / FLAIR brain MRI demonstrating progression in the size and number of hyperintensities (arrows) visualized in the MRI in panel A. C, Post-contrast axial T1-weighted brain MRI demonstrating multiple ring enhancing lesions (white arrow) and basilar meningitis (yellow arrow) as well as severe hydrocephalus. D, Periodic acid-Schiff stained section of brain parenchyma shows necrotizing vasculitis, chronic inflammatory cells, and a population of amoebic trophozoites that closely resemble macrophages (arrows), 400×. The majority of the tissue showed a robust necrotizing vasculitis with mixed inflammation including macrophages and numerous eosinophils. E, Immunohistochemistry for free-living amoebas highlights numerous B. mandrillaris trophozoites, 400× (courtesy of M.K.K., CDC).