Cerebral toxoplasmosis with multiple hemorrhage lesions in an HIV infected patient: A case report and literature review

Hosoda, Tomohiro; Mikita, Kei; Ito, Mamoru; Nagasaki, Hirokazu; Sakamoto, Mitsuo

doi:10.1016/j.parint.2020.102280

Cited by 10 publications

(2 citation statements)

References 14 publications

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“…A re-examination of the CT scan after 2 weeks of antitoxoplasmic treatment revealed a previously undetected haemorrhagic lesion in the left thalamus as a hyperdense area. Authors suggest that a part of prehaemorrhagic as ischaemic lesions could remain unde-e391 © Pol J Radiol 2023; 88: e389-e398 tected in the initial CT scan in patients with haemorrhagic cerebral toxoplasmosis [17].…”

Section: Computed Tomographymentioning

confidence: 99%

Evaluation of imaging methods in cerebral toxoplasmosis

Zawadzki,

Modzelewski,

Naumowicz

et al. 2023

Pol J Radiol

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Cerebral toxoplasmosis is a parasitic disease resulting, in most cases, from a reactivation of a latent cyst with <i>Toxoplasma gondii</i>. The disease mainly affects immunosuppressed individuals, such as HIV (human immunodeficiency virus)-infected patients. Diagnosis is based on specialized antibody testing, clinical symptoms, neuroimaging methods, and histological examination. The gold standard for diagnosis is a brain biopsy, but more often the response to treatment seen in clinical symptoms and neuroimaging studies is sufficient. The imaging features support the diagnosis of cerebral toxoplasmosis and help assess the effectiveness of treatment.

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Section: Computed Tomographymentioning

confidence: 99%

Evaluation of imaging methods in cerebral toxoplasmosis

Zawadzki,

Modzelewski,

Naumowicz

et al. 2023

Pol J Radiol

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“…The spread of these parasites is related to the patient’s immune response, in hosts with a decreased immune system, the infection can reactivate so that it can cause manifestations in the central nervous system 1 . Cerebral toxoplasmosis is often found in patients with acquired immune deficiency syndrome (AIDS) 2 , 3 . This accounts for approximately 50-70% of all brain lesions in immunodeficient patients, clinical manifestations usually appear in the late stages of AIDS, when the CD4 level is below 200 cells/mm 3 , and patients with CD4 below 50 cells/mm 3 is at most significant risk 4 , 5 .…”

Section: Introductionmentioning

confidence: 99%

Significant clinical outcome using pyrimethamine and clindamycin in cerebral toxoplasmosis with severe edema: a case report

Basmalah

Sugianto

2023

Annals of Medicine &Amp; Surgery

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Introduction and Importance: Cerebral toxoplasmosis is a complication in HIV/AIDS patients that has recently increased in new cases due to increased HIV/AIDS incidents. Case Presentation: An Indonesian male, 26-year old, complained of severe headache, left hemiparesis, and tremors. A brain computed tomography scan with contrast showed a large mass, extensive edema, and a significant midline shift resembling a brain tumor. The HIV test was positive, and CD4 decreased. The patient was treated with dexamethasone, mannitol, and pyrimethamine-clindamycin as therapy. After 2 weeks of treatment, the headache, hemiparesis, and tremor were clinically improved. Two months later, a brain computed tomography scan and MRI showed a good prognosis. Clinical Discussion: The diagnosis of cerebral toxoplasmosis is based on a radiological examination and an HIV/AIDS test. Management of cerebral toxoplasmosis using pyrimethamine-clindamycin, while steroids are not recommended unless disproportionate cytotoxic edema is displayed and life-threatening. Conclusion: A combination of pyrimethamine-clindamycin, and steroids can improve the prognosis of cerebral toxoplasmosis with severe edema.

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