CNS Infections in Immunoincompetent Patients

Weidauer, Stefan; Wagner, Marlies; Enkirch, Simon Jonas; Hattingen, Elke

doi:10.1007/s00062-019-00837-6

Cited by 10 publications

(10 citation statements)

References 107 publications

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“…Persistent lymphopenia or marked drop of lymphocytes is a known risk factor for opportunistic CNS infection [32]. Of note, HSE has been reported not only after immunosuppressive therapy but also in multiple sclerosis (MS) by lymphocyte-lowering immunotherapies or interference with the migratory action of lymphocytes [10,33,34].…”

Section: Discussionmentioning

confidence: 99%

Cerebral HSV-1 Vasculitis as a Fatal Complication of Immunosuppression in Non-Hodgkin´s Lymphoma: A Case Report and Review of the Literature

Nardone

Carnicelli²,

Brigo³

et al. 2020

Pathogens

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Patients with lymphoma are predisposed to infection because of the immunocompromised state related to the disease itself and as a consequence of chemo-/radiotherapy. Here, we report a case of Herpes-simplex virus encephalitis (HSE) in an immunosuppressed patient with splenic marginal zone lymphoma (SMZL), a rare indolent variant of non-Hodgkin´s lymphoma (NHL). The course was complicated febrile neutropenia and HSV-1-related cerebral vasculitis causing progressive ischemic stroke. This case illustrates the expanding spectrum of atypical clinical and radiological manifestations of HSE in patients treated with myelotoxic drugs. Moreover, we summarize the few central nervous system manifestations of SMZL reported in the literature and discuss distinct causes of neurological deterioration in patients with NHL.

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Section: Discussionmentioning

confidence: 99%

Cerebral HSV-1 Vasculitis as a Fatal Complication of Immunosuppression in Non-Hodgkin´s Lymphoma: A Case Report and Review of the Literature

Nardone

Carnicelli²,

Brigo³

et al. 2020

Pathogens

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“…5) [1,15] and pathogen-induced inflammatory CNS diseases (see ▶ Fig. 6) [39]. The most common causes of cerebral white matter lesions are discussed below.…”

Section: Para-and Perivascular Spaces (Pvs)mentioning

confidence: 99%

“…However, it is important to remember here that both autoimmune-associated inflammations such as multiple sclerosis (MS) [12, [56][57][58] or NMOSD (Neuromyelitis Optica Spectrum Disorders) [59,60] as well as pathogen-related infections can cause a diffusion restriction in the acute phase, although it is usually lesser compared to an acute cerebral infarction (see ▶ Fig. 11) [39]. In contrast to cytotoxic edema, vasogenic edema, particularly in blood-brain barrier disruption, typically shows an anatomically predetermined extension along fascicles and fiber structures (see ▶ Fig.…”

Section: Lacunar Infarctsmentioning

confidence: 99%

“…Vascular-associated diseases as well as inflammatory and neoplastic processes may exhibit an angiocentric lesion pattern on T2 WI due to the anatomically predetermined propagation along the PVS, which is illustrated by taking into account the T1 WI after contrast application (pc T1 WI) [39,[66][67][68][69]. In addition to sarcoidosis (see ▶ Fig.…”

Section: Angiocentric Propagation Patternmentioning

confidence: 99%

“…In addition to sarcoidosis (see ▶ Fig. 15) [67,68], in particular fungal infections [39], primary CNS lymphoma (PCNSL) as well as related diseases (e. g. lymphomatoid granulomatosis) [70] show a streaky or punctiform enhancement, with possibly continuous Gadolinium enhancement of the perivascular leptomeningeal structures along the course of the perforators with differently pronounced perifocal edematous (T2-hyperintense) reaction and possible circumscript diffusion restriction due to inflammation, high cell density or a resulting infarction.…”

Section: Angiocentric Propagation Patternmentioning

confidence: 99%

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White Matter Lesions in Adults – a Differential Diagnostic Approach

Weidauer

Wagner

Hattingen

2020

Rofo

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Objective Cerebral white matter lesions on MRI in adults are a common finding. On the one hand, they may correspond to a clinically incidental feature, be physiologically or age-associated, or on the other hand they may be the overture to a severe neurological disease. With regard to pathophysiological aspects, practical hints for the differential diagnostic interpretation of lesions in daily clinical practice are presented. Material and Methods With special regard to the vascular architecture and supply of the cerebral white matter, physiological structures are schematically represented and pathophysiological processes are highlighted by comparative image analysis of equally angulated MR sequences. Results The most frequent vascular, inflammatory, metabolic, and neoplastic disease entities are presented on the basis of characteristic imaging findings and corresponding clinical- neurological constellations. The details of signal intensities and localization essential for differential diagnosis are highlighted. Conclusion By means of comparative image analysis and the recognition of characteristic lesion patterns, taking into account anatomical principles and pathophysiological processes, the differential diagnostic classification of cerebral white matter lesions and associated diseases can be significantly facilitated. The additional consideration of clinical and laboratory findings is essential. Key Points: Citation Format

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