CNS toxoplasmosis in an immunocompetent individual

Ramachandran, Rajoo; Radhan, Prabhu; Anand, Rajamani; Ilanchezhian, Subramanian; Santosham, Roy; Sai, Venakata

doi:10.2484/rcr.v9i1.908

Cited by 20 publications

(13 citation statements)

References 12 publications

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“…Because there are various studies and case reports that showed hypointense lesions on T1-weighted MRI in toxoplasmosis. [22][23][24] However, in T2-weighted MRI, a high prevalence of hyperintense lesions was observed (79.4%). This also can be linked to the increased prevalence of toxoplasmosis in the study group, as T2-weighted MRI in toxoplasmosis shows hyperintensive lesions.…”

Section: Discussionmentioning

confidence: 99%

Role of Magnetic Resonance Imaging in Evaluation of the Brain Lesions in HIV-infected Patients: A Prospective Observational Study

Bhanushali¹,

Patil²

2019

IJCMSR

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Imaging technologies play an important role in guiding accurate diagnosis and proper therapy in neuronal complications induced by HIV. Impact of HIV in the CNS can be well assessed by magnetic resonance imaging (MRI). MRI can favorably show the range and depth of soft tissue infections, and necrosis and has a higher sensitivity to pick up new lesions; hence making it the modality of choice. It helps to understand the pathological process and disease progression, non-invasively. 5,6 Therefore, in the present study, MRI was used to differentiate and characterize the brain lesions in the HIV-infected patients.

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Section: Discussionmentioning

confidence: 99%

Role of Magnetic Resonance Imaging in Evaluation of the Brain Lesions in HIV-infected Patients: A Prospective Observational Study

Bhanushali¹,

Patil²

2019

IJCMSR

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“…Patients usually present with headache, confusion, or changes in the level of consciousness, fever, focal neurological signs, and seizure [22,23]. Presentation with meningeal signs and diffuse encephalitis is less common [24].…”

Section: Discussionmentioning

confidence: 99%

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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“…Cerebral toxoplasmosis is usually associated with immunodeficiency conditions. However, the incidence of cerebral toxoplasmosis in an immunocompetent host, especially with poor nutritional hygiene, has been reported . Neuroimaging features in these patients tend to differ as the lesions are linear in morphology and are located at the grey‐white matter junction with a centripetal spread along the Virchow‐Robin spaces.…”

Section: Discussionmentioning

confidence: 99%

“…However, the incidence of cerebral toxoplasmosis in an immunocompetent host, especially with poor nutritional hygiene, has been reported. 11,12 Neuroimaging features in these patients tend to differ as the lesions are linear in morphology and are located at the grey-white matter junction with a centripetal spread along the Virchow-Robin spaces. Our patient was a smoker but otherwise in good health, with negative clinical or typical radiological features for toxoplasmosis; however, autopsy was confirmatory for cerebral toxoplasmosis without any evidence for immunodeficiency.…”

Section: Discussionmentioning

confidence: 99%