LAUSR

A 3-month-old boy developed fever and had repeated overdose of acetaminophen with a total dose of 1500 mg (300 mg/kg) over 3 days due to dosage miscalculation. He was admitted and N-acetylcysteine was given. He progressed to have acute liver failure. Extensive investigations did not show any other cause. Continuous venovenous haemodiafiltration was started and he was listed for liver transplantation. While waiting for organ, there was a period that he had severe coagulopathy (prothrombin time 127 s, international normalised ratio 13.3 and activated partial thromboplastin time 163 s). Surveillance cranial ultrasound showed cystic lesions. Computed tomography showed two lesions with blood-fluid level appearance in bilateral frontal lobes. Right frontal lobe lesion is shown in Figure 1. What is the diagnosis and what explains such appearance? (Answer on page 874)