Evaluation of different techniques in the diagnosis of Toxoplasma encephalitis

Rodríguez, José Carlos del Castillo; Martínez, Magdiel; Martı́nez, Antón; Royo, Gloria

doi:10.1099/00222615-46-7-597

Cited by 17 publications

(11 citation statements)

References 30 publications

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“…The authors suggested that regarding to heterogeneity in the appearance of lesions on T2-weighted images is hard to make a definitive diagnosis based on signal characteristics alone, as it is the case presented here with no diagnosis within one month of admission. It has been proposed that the transition from hyperintensity to isointensity may reflect a response to antibiotic therapy, and that such signal changes could be used to assess the effectiveness of medical therapy (8). Similar findings in our case with loss of hyperintensity on T2-weighted images and transition to isointensity on T1-weighted images after specific therapy parallel to clinical improvement support this opinion.…”

Section: Discussionsupporting

confidence: 88%

“…However, serological tests may not be useful for the diagnosis of CNS involvement as in our patient who had high serum IgG titers with no IgM antibodies and a high avidity rate. It has been noticed that the detection of antibodies and IgG avidity were not diagnostic and the detection of serum antigens by enzyme linked immunosorbent assay (ELISA) had a low sensitivity (8). The test with the highest diagnostic yield was the detection of DNA by polymerase chain reaction (PCR) which was also diagnostic in our patient.…”

Section: Discussionmentioning

confidence: 78%

See 1 more Smart Citation

İmmun Bağışıklığı Normal Olan Bir Hastada Diffüz Serebral Toksoplazmozis

Kumral¹,

Köşkderelioğlu²,

Atalay³

et al. 2012

tnd

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 78%

İmmun Bağışıklığı Normal Olan Bir Hastada Diffüz Serebral Toksoplazmozis

Kumral¹,

Köşkderelioğlu²,

Atalay³

et al. 2012

tnd

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“…Knowledge of the specific treatment and the sample collection during the first week of specific therapy is an important tool for PCR sensitivity (34,40). In agreement, we only collected CSF samples from patients who had received anti-toxoplasmosis treatment up to day 3.…”

Section: Discussionmentioning

confidence: 51%

PCR Assay Using Cerebrospinal Fluid for Diagnosis of Cerebral Toxoplasmosis in Brazilian AIDS patients

Vidal¹,

Colombo

Oliveira

et al. 2004

J Clin Microbiol

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Highly active antiretroviral therapy has decreased the incidence of opportunistic infections in the central nervous system in AIDS patients. However, neurological abnormalities still remain important causes of mortality and morbidity in developing countries. In Brazil, cerebral toxoplasmosis is the most common cerebral mass lesion in AIDS patients. For these reasons, early, inexpensive, and sensitive diagnostic tests must be evaluated. The aim of this study was to evaluate PCR, using cerebrospinal fluid (CSF) samples to detect Toxoplasma gondii DNA, and to determine if the association of PCR with immunological assays can contribute to a timely diagnosis. We studied two sample groups. First, we analyzed stored CSF samples from 29 newborns and from 39 adults with AIDS without a definitive diagnosis of toxoplasmosis. The goal of this step was to standardize the methodology with a simple and economical procedure to recover the T. gondii DNA. Next, we prospectively evaluated CSF samples from 12 AIDS patients with a first episode of cerebral toxoplasmosis and 18 AIDS patients with other neurological opportunistic diseases and without previous cerebral toxoplasmosis. In all PCR samples, an indirect immunofluorescent assay and an enzyme-linked immunosorbent assay were performed. Samples from all patients with cerebral toxoplasmosis presented positive PCR results (sensitivity, 100%), and a sample from one of the 18 AIDS patients with other neurological diseases also presented positive PCR results (specificity, 94.4%). These findings suggest the clinical utility of PCR in the diagnosis of cerebral toxoplasmosis in developing countries.

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“…These issues include variations in techniques [17] and standardization in microbiology laboratories. Interpretation of PCR results should also take into consideration whether the patient is receiving specific treatment [15].…”

Section: Diagnosismentioning

confidence: 99%

Central nervous system toxoplasmosis in HIV pathogenesis, diagnosis, and therapy

Luft

Chua

2000

Curr Infect Dis Rep

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In patients with HIV, Toxoplasma gondii is the most frequent infectious cause of focal brain lesions. Particularly in advanced HIV disease, it can cause significant morbidity and mortality. Current clinical practice involves empiric therapy with pyrimethamine and sulfadiazine, upon a presumptive diagnosis of toxoplasmic encephalitis, based on serologic, clinical, and radiological features. This approach continues to evolve, as new diagnostic strategies, such as the use of immunoglobulin G antibody titers and polymerase chain reaction, prophylaxis against opportunistic infections, and highly active antiretroviral therapy--HAART--come into play. Primary and secondary prophylaxis are the mainstay of treatment. There remains a continuing need for development of new anti-Toxoplasma therapy.

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Evaluation of different techniques in the diagnosis of Toxoplasma encephalitis

Cited by 17 publications

References 30 publications

İmmun Bağışıklığı Normal Olan Bir Hastada Diffüz Serebral Toksoplazmozis

İmmun Bağışıklığı Normal Olan Bir Hastada Diffüz Serebral Toksoplazmozis

PCR Assay Using Cerebrospinal Fluid for Diagnosis of Cerebral Toxoplasmosis in Brazilian AIDS patients

Central nervous system toxoplasmosis in HIV pathogenesis, diagnosis, and therapy

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