Cerebral toxoplasmosis in acquired immuno deficiency syndrome

Gaston, André; Gherardi, Romain K.; Nguyen, Justin; Perroud, A. M.; Wechsler, J; Wallman, James F.; Bras, Fabien Le; Marsault, C.

doi:10.1007/bf00342523

Cited by 14 publications

(2 citation statements)

References 13 publications

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“…CT findings can be often misleading; the most common finding is a low density intraparenchymatous mass lesion; after contrast injection there is a ringshaped or a homogeneous enhancement with perifocal oedema; a central enhanced point may be visible H, 17, 25 These findings are not specific since no distinctive criteria with the other opportunistic infections or primary or metastatic neoplasms can be established in such patients 11,17 Brain biopsy, which enables an accurate diagnosis by histological study of a cerebral lesion, has already been proven a very helpful procedure also because of the high incidence of polymicrobial infections 17. Since cerebral toxoplasmosis in AIDS patients is thought to be due to revival of quiescent intraparenchymatous cysts 3, 32 and since this infection is very frequent in our population of non-AIDS patients 23 we opted for a trial of medical therapy with trimethoprim/sulfamethoxazole for presumptive Toxoplasma gondii opportunistic infection before performing a brain biopsy.…”

Section: Discussionmentioning

confidence: 99%

Intracerebral mass lesions in patients affected by AIDS

et al. 1986

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"Toxoplasma gondii" cerebral abscess is a common opportunistic infection in patients affected by AIDS. Making a reliable diagnosis of acute cerebral toxoplasmosis is difficult in AIDS patients because of the lack of specificity of serological data and neuroradiological findings. Brain biopsy is the only procedure which enables a reliable diagnosis to be made a trial of specific medical therapy for toxoplasmosis in patients affected by AIDS and intracranial mass lesion can be advisable before performing brain biopsy. The authors report the cases of three patients affected by AIDS and cerebral toxoplasmosis. Tissue diagnosis was made in the first patient from autopsy material while a presumptive diagnosis was made in the other two cases since specific medical therapy resulted in a dramatic improvement of the neurological status. Despite the good possibilities in the treatment of this complication AIDS, however, carries a poor prognosis.

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Section: Discussionmentioning

confidence: 99%

Intracerebral mass lesions in patients affected by AIDS

et al. 1986

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“…Typical imaging findings include multiple abscess formation with a propensity for the basal ganglia, corticomedullary junction, white matter, and periventricular regions. CT can demonstrate areas of low-attenuation or iso-attenuation nodules, both of which can show varying degrees of enhancement (24,44). MRI features include multiple, high T2WI signal lesions with vasogenic edema and ring or nodular enhancement (19).…”

Section: Human Immunodeficiency Virus (Hiv)mentioning

confidence: 99%

Intracranial infections: clinical and imaging characteristics

et al. 2007

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The radiologist plays a crucial role in identifying and narrowing the differential diagnosis of intracranial infections. A thorough understanding of the intracranial compartment anatomy and characteristic imaging findings of specific pathogens, as well incorporation of the clinical information, is essential to establish correct diagnosis. Specific types of infections have certain propensities for different anatomical regions within the brain. In addition, the imaging findings must be placed in the context of the clinical setting, particularly in immunocompromised and human immunodeficiency virus (HIV)-positive patients. This paper describes and depicts infections within the different compartments of the brain. Pathology-proven infectious cases are presented in both immunocompetent and immunocompromised patients, with a discussion of the characteristic findings of each pathogen. Magnetic resonance spectroscopy (MRS) characteristics for several infections are also discussed.

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Skeletal muscle toxoplasmosis in patients with acquired immunodeficiency syndrome: A clinical and pathological study

Gherardi¹,

Baudrimont²,

Lionnet

et al. 1992

Annals of Neurology

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The present article describes the clinical and pathological findings in 5 human immunodeficiency virus (HIV)-infected patients with muscle toxoplasmosis. The patients had marked lymphopenia (5/5), with less than five CD4+ cells/mm3 (3/3), when they developed fever (5/5), and multiorgan failure (5/5), including diffuse encephalitis, pneumonia, pancytopenia, and myopathy. Muscle involvement included weakness and wasting (4/5), myalgias (3/5), and high serum creatine kinase levels (3/3). Serology for toxoplasmosis showed high IgG titers in 3 patients (3/4). Anti-Toxoplasma therapy resulted in complete recovery in 2 patients. Muscle toxoplasmosis was detected by biopsy (3/5) or postmortem evaluation (2/5), and was identified using immunocytochemistry and electron microscopy. Toxoplasma cysts were detected in 0.5 to 4% of muscle fibers close to or remote from necrotic fibers and inflammatory infiltrates. Muscle fibers strongly expressed the major histocompatibility complex class I antigen (2/2) as in polymyositis. We suggest that Toxoplasma gondii should be sought by muscle biopsy in patients who have acquired immunodeficiency syndrome with fever, encephalitis, multiorgan dysfunction, and elevated serum creatine kinase levels of obscure origin.

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Cerebral toxoplasmosis in acquired immuno deficiency syndrome

Abstract: Authors report a case of fatal CNS toxoplasmosis in a young homosexual man suffering from Kaposi angio-sarcoma. This paper is principally concerned with CT scan and neuropathological correlations.

Cited by 14 publications

References 13 publications

Intracerebral mass lesions in patients affected by AIDS

Intracerebral mass lesions in patients affected by AIDS

Intracranial infections: clinical and imaging characteristics

Skeletal muscle toxoplasmosis in patients with acquired immunodeficiency syndrome: A clinical and pathological study

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