Cerebral toxoplasmosis with fever and erythematous macular rash: An initial presentation in an advanced HIV infection

Barman, Bhupen; Tiewsoh, Iadarilang; Lynrah, Kryshanlang G; Wankhar, Baphiralyne; Issar, Neel Kanth

doi:10.4103/tp.tp_91_15

Cited by 7 publications

(8 citation statements)

References 8 publications

(7 reference statements)

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“…However, it is exceedingly rare for cerebral toxoplasmosis to be the initial manifestation of HIV/AIDS. Three cases have been reported thus far with each case leading to the diagnosis of disseminated cerebral toxoplasmosis as the initial presentation of HIV/AIDS [ 6 , 7 ]. Further details about the presentation, management, and outcomes of these cases are summarized along with our cases in Table 1 .…”

Section: Discussionmentioning

confidence: 99%

“…It is also an important AIDS-defining illness, presenting as the disease progresses without anti-retroviral therapy (ART), with an onus of high morbidity and mortality [ 5 ]. Conversely, reported cases of CNS toxoplasmosis as the ﬁrst presentation of individuals infected with HIV/AIDS are exceedingly rare, with only a handful of cases in the literature [ 6 , 7 , 8 ]. We identified three unique cases presenting to our hospital with neuropsychiatric symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral Toxoplasmosis As the Initial Presentation of HIV: A Case Series

Khosla

Singhal

Jotwani

et al. 2022

Cureus

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cerebral Toxoplasmosis As the Initial Presentation of HIV: A Case Series

Khosla

Singhal

Jotwani

et al. 2022

Cureus

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“…Infrequently, cerebral toxoplasmosis present as the first manifestation of HIV/AIDS, which is life-threatening if left untreated [17][18][19]. Here, we describe a very rare case of a child who presented with diffuse cerebral toxoplasmosis as the first manifestation of pediatric HIV/AIDS.…”

Section: Introductionmentioning

confidence: 92%

Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature

et al. 2020

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Unusual clinical course Background: One of the most common causes of central nervous system (CNS) opportunistic infections in immunocompromised patients is toxoplasmosis. It can cause focal or disseminated brain lesions leading to neurological deficit, coma, and death. Prompt management with optimal antibiotics is vital. However, the diagnosis of cerebral toxoplasmosis is challenging in infected individuals with human immunodeficiency virus (HIV). The possible diagnosis is based on clinical presentation, imaging, and specific serologic investigations. The diagnosis can be confirmed by histopathological examination and/or by finding nucleic material in the spinal cerebrospinal fluid (CSF) examination. Case Report: We present a review of the literature with a rare illustrative case of diffuse CNS toxoplasmosis as the first manifestation of HIV infection in a young patient. Brain MRI showed diffuse, ring-enhancing lesions, and significant midline shift. Decompressive hemicraniectomy for control of intracranial pressure and anti-infectious therapy were performed. Conclusions: This should raise awareness that cerebral toxoplasmosis can occur in pediatric patients with HIV infection, and, more importantly, as the first manifestation of AIDS. Although the prognosis is often poor, early diagnosis and immediate treatment of this life-threatening opportunistic infection can improve outcomes.

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“…A identificação de uma ou mais lesões cerebrais em contexto focal, apresentando pressão de massa exercida concomitante com a evidência de DNA de T. gondii no LCR por ensaios de amplificação de ácido nucleico também norteiam o diagnóstico. Portanto, o pilar diagnóstico se estabelece naqueles casos em que se tem uma clínica compatível com a patologia como mencionado anteriormente, associado a uma lesão característica com captação anelar de contraste iso ou hipodensa com resposta extremamente favorável à terapia empírica (BARMAN B, et al, 2018).…”

Section: Revisão Bibliográficaunclassified

“…Escola de Medicina Souza Marques (EMSM), Rio de Janeiro -RJ 2. Universidade Estácio de Sá (UNESA), Rio de Janeiro -RJ.SUBMETIDO EM: 9/2022 | ACEITO EM: 9/2022 | PUBLICADO EM: 9/2022…”

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Neurotoxoplasmose em portadores de síndrome da imunodeficiência humana: revisão de literatura

Filho

Mourão²,

Hissi³

et al. 2022

Acervo Médico

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Objetivo: Correlacionar o manejo diagnóstico terapêutico da Neurotoxoplasmose ao desfecho de morbimortalidade nos indivíduos portadores de Síndrome da Imunodeficiência Humana. Revisão bibliográfica: A toxoplasmose é uma doença provocada pelo Toxoplasma gondii, parasita intracelular semeado pelo Brasil, que pode se instalar e gerar infectividade ao Sistema Nervoso Central (SNC). Em razão da imunodeficiência marcante do dinamismo fisiopatológico do HIV, esses indivíduos são inoperantes no controle da expansão e diferenciação do patógeno possibilitando reativação e menos frequentemente uma infecção aguda com repercussões no SNC como cefaleia, confusão mental, convulsões e alterações de força. Como pilar essencial do diagnóstico ancora-se a história clínica epidemiológica a Ressonância Magnética do Crânio com lesão hipo/isodensa com captação anelar do contraste e efeito de massa exercido. Considerações finais: Nessa perspectiva, com a maior facilidade de acesso à Terapia Antiretroviral atualmente é possível observar, ao longo dos anos, uma queda significativa da incidência de neurotoxoplasmose no Brasil. No entanto, a neurotoxoplasmose ainda é uma causa significativa de morbidade e mortalidade em pacientes imunossuprimidos, sendo importante reconhecer, conseguir diagnosticar e tratar tal patogenia de maneira efetiva, pois o intervalo de tempo entre o diagnóstico e o início do tratamento é determinante na morbimortalidade.

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Cerebral toxoplasmosis with fever and erythematous macular rash: An initial presentation in an advanced HIV infection

Cited by 7 publications

References 8 publications

Cerebral Toxoplasmosis As the Initial Presentation of HIV: A Case Series

Cerebral Toxoplasmosis As the Initial Presentation of HIV: A Case Series

Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature

Neurotoxoplasmose em portadores de síndrome da imunodeficiência humana: revisão de literatura

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