• Serbulent Kilic, Hasan Burak Kaya, Ridvan Sarikaya, and GuvenFatma Mutlu KukulFMKDepartment of Emergency Medicine, Kastamonu Training and Research Hospital, Kastamonu, Turkey..
• Department of Forensic Medicine, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey.
• J Coll Physicians Surg Pak. 2023 Jan 1; 33 (1): 808280-82.

AbstractFrom the perspective of forensic medicine, substance abuse is an important topic due to its nature and consequences. The usage of methamphetamine is a significant public health problem with deleterious side effects, one of the most serious of which is mimicking central nervous system infection. A 40-year man was brought to the emergency department with complaints of headache, vomiting, fever, and loss of consciousness. According to his relative, he had abstained from methamphetamine abuse for two weeks. The initial diagnosis was made of methamphetamine withdrawal symptoms. However, computed tomography of the head revealed sinusitis and a hypodense lesion with dimensions of 35 x 35 mm. Moreover, Streptococcus agalactiae (group B streptococcus) was grown in the blood culture. A diagnosis of brain abscess and ventriculitis was made. The aim of this report is to draw physicians attention to substance abstinence symptoms that may mask more serious diseases. Key Words: Brain abscess, Methamphetamine withdrawal, Sinusitis.

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