Occam or Hickham? The diagnostic dilemma of an inflammatory brain lesion in the setting of pulmonary aspergillosis and previous neurosurgery.

This case illustrates the importance of pathological diagnosis to guide therapy and reminds us that the occasional patient will encounter multiple, rare and unrelated diseases during their lifetime. A high index of suspicion is necessary in patients who have undergone surgical aneurysm repair involving muslin as it may be subject to secondary infection and or granuloma formation many years later.