Intracranial Mass Lesions in Human Immunodeficiency Virus Patients in the Philippines: A Retrospective Cohort Study

Nepomuceno, Marisse; Salvaña, Edsel Maurice; Chua, Annabell E.

doi:10.1016/j.wneu.2020.09.141

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…На фоне целенаправленного лечения в течении 2-4 нед отмечается положительная клиническая и МР-динамика, чего не будет при других заболеваниях и опухолях головного мозга [5,6,8]. В случаях отсутствия улучшения в эти сроки рекомендуется проведение биопсии с окончательной верификацией диагноза по результатам гистологических и иммуногистохимических исследований [4,7,10]. Специальные методы окраски (ШИК-реакция, метенамин-серебро) позволяют выявить колонии токсоплазм [9,10].…”

Section: Discussionunclassified

“…Заболевание проявляется общемозговой симптоматикой (в первую очередь выраженной головной болью), лихорадкой, расстройством уровня бодрствования, очаговыми выпадениями, нарушениями поведения и судорожными приступами [6,7,9,10]. Лихорадка отмечается более чем в 50% случаев, что необходимо учитывать в дифференциальной диагностике с церебральными новообразованиями.…”

Section: рис 3 мскт головного мозга пациентки р с контрастным усилени...unclassified

“…В 10-20% случаев неврологические нарушенияпервые проявления ВИЧ [5]. Церебральный токсоплазмоз (ЦТ) -наиболее частая оппортунистическая инфекция, поражающая центральную нервную систему (ЦНС) у пациентов со СПИД [1,[5][6][7][8].…”

Section: Introductionunclassified

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A case series of cerebral toxoplasmosis in the practice of a neurological hospital

Shnyakin

Botov

Rudenko

et al. 2023

Annals of Clinical and Experimental Neurology

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Introduction. Central nervous system is one of the main targets in patients with HIV infection. Neurological complications in AIDS are primarily caused by opportunistic brain infections including toxoplasmosis as the most common one. Patients with cerebral toxoplasmosis are often hospitalized with diagnosed strokes, tumors, or encephalitis. At that, their HIV status may be unknown and their state severity often does not allow conducting the range of required examinations. Materials and methods. We have described our experience in management of 6 patients admitted to the neurosurgery department with single toxoplasmosis foci and diagnosed brain tumors. Results. HIV infection was initially known in 3 patients only. In 2 compensated patients, the diagnosis was confirmed via Toxoplasma IgG blood test. In 2 individuals, negative serological Toxoplasma reactions were followed by neuronavigationally controlled biopsies. A patient with an extensive perifocal edema and, as a result, dislocated midline structures underwent decompressive craniectomy and mass removal. One female patient, with an unclear diagnosis, was operated for a suspected brain tumor. After additional assessments (including 4 histologies to confirm cerebral toxoplasmosis), all the patients were transferred to the infectious disease hospital for specific treatment.

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Section: Discussionunclassified

Section: рис 3 мскт головного мозга пациентки р с контрастным усилени...unclassified

Section: Introductionunclassified

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A case series of cerebral toxoplasmosis in the practice of a neurological hospital

Shnyakin

Botov

Rudenko

et al. 2023

Annals of Clinical and Experimental Neurology

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“…Since its discovery in the 1980s, HIV has increasingly become a chronic condition with a life expectancy similar to the general population due to the advent of therapy with HAART [ 5 ]. Most of the existing literature on HIV and brain tumors focus on tumor prevalence in HIV-positive populations rather than the HIV prevalence in tumor patients [ 6 , 7 ]. The use of HAART has dramatically added to the longevity of HIV-positive, seronegative patients, who are now living long enough to develop a range of cancers thought to arise in part due to reduced immune surveillance, direct effects of HIV, or oncogenic viral infection.…”

Section: Discussionmentioning

confidence: 99%

Human Immunodeficiency Virus in Adults Undergoing Surgery for Brain Tumors

Harris¹,

Rahman²,

Khoudir³

et al. 2022

Cureus

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IntroductionEarly diagnosis and treatment of human immunodeficiency virus (HIV) can improve outcomes. HIV prevalence in brain tumor patients and the impact of an HIV diagnosis on patient outcomes are poorly understood. Materials and methodsThis was a prospective study of 100 consecutive brain tumor patients admitted to a Greater London Tertiary Neurosurgical center for surgery between January 2021 and October 2021. All brain tumors were included. All patients have appropriately consented. Blood was tested to detect HIV antibodies and p24 antigen.Outcomes were noted at 30-day postoperative follow-up. ResultsIn 100 patients, there was one case of a known HIV-positive, seronegative patient, and no new diagnosis was made, giving a prevalence of 1%. The mean age of patients included was 61.7 ± 13.3, with 57% female. The patient with HIV suffered a postoperative pseudomonas infection, requiring intensive care, additional surgery, and antibiotics. This resulted in an inpatient stay of 55 days -an increase of 274% compared to patients without HIV. ConclusionLiterature regarding the prevalence of HIV in glioma patients is inconclusive, of low quality, and primarily out-of-date. Our literature search found no similar study of rates of HIV in brain tumor patients in the United Kingdom. The incidence of both HIV and brain tumors, particularly glioblastomas, is low.

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“…At CD4 counts of less than 200 cells/µL, the most common differential diagnoses are toxoplasmosis, lymphoma, abscesses, metastases, tuberculosis and fungal infections. In addition, multiple etiologies can coexist in immunosuppressed patients [5].…”

Section: Discussionmentioning

confidence: 99%

Differential diagnosis of brain lesions in a metastatic endometrial carcinosarcoma patient

Arsad¹,

Yong²,

Teo³

2021

ecancer

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The differential diagnosis of ring-enhancing brain lesions in a patient with metastatic malignancy may initially seem straightforward, and easily attributed to brain metastases. On rare occasions, the physician needs to avoid anchoring bias by re-evaluating the entire clinical context in which these ring-enhancing brain lesions are found. We report a case of cerebral toxoplasmosis mimicking brain metastases in a patient with metastatic cancer and without a prior history of human immunodeficiency virus. A 65-year-old lady with a recently detected relapse of her endometrial carcinosarcoma presented with a 2-week history of fever with no localising symptoms or signs of infection. The initial investigations were unremarkable. She had daily fever despite empirical broad-spectrum antibiotics. A positron emission tomography-computed tomography (PET-CT) was performed to evaluate the pyrexia of unknown origin, which showed metastatic deposits in the pelvis. A magnetic resonance imaging (MRI) of the brain was subsequently performed due to fluctuating mentation, which reported metastatic disease to the brain. Her pyrexia of unknown origin was attributed to malignancy-related fever. The medical oncologist was cautious about starting systemic treatment because the PET-CT had FDG-avid diffuse ground glass opacities in both lung fields, and requested for a bronchoscopic evaluation, which returned positive for Pneumocystis jirovecii. In light of this new finding, a multidisciplinary discussion and a review of the brain MRI were undertaken, during which it was concluded that the likelihood of cerebral toxoplasmosis was much higher than brain metastases. She was treated with high dose trimethoprim-sulfamethoxazole for both P. jirovecii pneumonia and cerebral toxoplasmosis, with clinical and radiological improvement. This case highlights the importance of (a) clinical input in interpreting imaging findings, (b) entertaining the possibility of multiple concurrent pathologies explaining a patient's symptoms, (c) being open to alternate diagnoses when new information surfaces even though the current working diagnosis is the most plausible and (d) multi-disciplinary communication when faced with diagnostic difficulty.

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Intracranial Mass Lesions in Human Immunodeficiency Virus Patients in the Philippines: A Retrospective Cohort Study

Cited by 5 publications

References 12 publications

A case series of cerebral toxoplasmosis in the practice of a neurological hospital

A case series of cerebral toxoplasmosis in the practice of a neurological hospital

Human Immunodeficiency Virus in Adults Undergoing Surgery for Brain Tumors

Differential diagnosis of brain lesions in a metastatic endometrial carcinosarcoma patient

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