Wrist pain, weak grip, and colonic mass

70 M OA, 25 lb wt loss/1 mo, L wrist electric shock pain, swelling/weak grip, osteonecrosis of scaphoid, passed out when getting out of bed, anemia, 3 cm colon mass. images shown. diagnosis?

MRI Head: Numerous enhancing intra-parenchymal lesions in cerebral & cerebellar hemispheres with surrounding vasogenic edema. Some lesions have central diffusion restrictions which suggest abscesses.

LP: CSF wbc 1, Glucose 74, Protein 40, CSF cult neg CSF crypto-, CSF HSV-, CSF lyme- CSF meningoencephalitis panel- HIV-, BC- histo/blasto-, bartonella-, legionella- RPR-, toxo IgG+, coxiella-, rickettsial panel-, WNV- Echo-

CT of chest, abdomen, pelvis: diffuse tiny upper lung nodularity, splenomegaly.

XR L wrist: osteonecrosis of scaphoid; diffuse osteoarthritis of hand

EEG: diffuse slowing GI bleed, colon ulcer

DDx? (Click next page to see answer!)

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