Imaging of Central Nervous System Parasitic Infections

Miranda, Thiago Augusto Vasconcelos; Tsuchiya, Kunihiko; Lucato, Leandro Tavares

doi:10.1016/j.nic.2022.07.013

Cited by 7 publications

(3 citation statements)

References 85 publications

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“…Neurologically, spinal cord spread is more common than spread to the brain. Up to 5% of myelopathy cases in endemic areas, including acute myelitis and subacute myeloradiculopathy of the lumbosacral region, have been attributed to schistosomiasis, associated most with S. mansoni or S. haematobium 103 . Patients can present with lumbar pain, lower limb radicular pain, muscle weakness, sensory loss, and bladder dysfunction.…”

Section: Parasitic Myelopathiesmentioning

confidence: 99%

Infectious Myelopathies

Fletcher,

Bhattacharyya

2024

CONTINUUM: Lifelong Learning in Neurology

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Objective Infectious myelopathy of any stage and etiology carries the potential for significant morbidity and mortality. This article details the clinical presentation, risk factors, and key diagnostic components of infectious myelopathies with the goal of improving the recognition of these disorders and guiding subsequent management. Latest Developments Despite our era of advanced multimodal imaging and laboratory diagnostic technology, a causative organism often remains unidentified in suspected infectious and parainfectious myelopathy cases. To improve diagnostic capability, newer technologies such as metagenomics are being harnessed to develop diagnostic assays with a greater breadth of data from each specimen and improvements in infection identification. Conventional assays have been optimized for improved sensitivity and specificity. Essential Points Prompt recognition and treatment of infectious myelopathy decreases morbidity and mortality. The key diagnostic tools include serologies, CSF analysis, and imaging; however clinical presentation, epidemiologic risk factors, and history of recent illness are all vital to making the proper diagnosis because current laboratory and imaging modalities are often inconclusive. The cornerstone of recommended treatment is targeted antimicrobials with appropriate immune modulation, surgical intervention, supportive care, and interdisciplinary involvement, all of which further improve outcomes for patients with infectious myelopathy.

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Section: Parasitic Myelopathiesmentioning

confidence: 99%

Infectious Myelopathies

Fletcher,

Bhattacharyya

2024

CONTINUUM: Lifelong Learning in Neurology

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“…PCNSL is one of the main differential diagnoses of neurotoxoplasmosis, in particular in the tumefactive variant. In this regard, slightly higher relative apparent diffusion coefficient values are reported in toxoplasmosis (ADC > 1.6 × 10 −3 mm 2 /s suggestive of toxoplasmosis; ADC < 1.1 × 10 −3 mm 2 /s pointing to lymphoma; intermediate values reported for both), as well as lower rCBV values (rCBV > 1.5 more common in lymphoma) [ 146 , 147 , 148 ]. In the paper by Dibble et al [ 148 ], previous studies used DSC-MRI for distinguishing abscess from glioblastoma and metastasis, and showed that the rCBV within the enhancing rims of abscesses is typically lower than that in necrotic glioblastomas and metastases [ 149 , 150 ].…”

Section: Neuroimaging Clues In the Main Differential Diagnosesmentioning

confidence: 99%

Tumor-like Lesions in Primary Angiitis of the Central Nervous System: The Role of Magnetic Resonance Imaging in Differential Diagnosis

Zedde,

Napoli,

Moratti

et al. 2024

Diagnostics

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Primary Angiitis of the Central Nervous System (PACNS) is a rare disease and its diagnosis is a challenge for several reasons, including the lack of specificity of the main findings highlighted in the current diagnostic criteria. Among the neuroimaging pattern of PACNS, a tumefactive form (t-PACNS) is a rare subtype and its differential diagnosis mainly relies on neuroimaging. Tumor-like mass lesions in the brain are a heterogeneous category including tumors (in particular, primary brain tumors such as glial tumors and lymphoma), inflammatory (e.g., t-PACNS, tumefactive demyelinating lesions, and neurosarcoidosis), and infectious diseases (e.g., neurotoxoplasmosis). In this review, the main features of t-PACNS are addressed and the main differential diagnoses from a neuroimaging perspective (mainly Magnetic Resonance Imaging—MRI—techniques) are described, including conventional and advanced MRI.

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“…Common parasitic causes of meningoencephalitis include cerebral toxoplasmosis and neurocysticercosis [36]. Uncommon diseases, such as primary amoebic meningoencephalitis and neuroschistosomiasis have been described [37].…”

Section: Fungal/parasitic Causesmentioning

confidence: 99%

Severe meningoencephalitis: epidemiology and outcomes

Thy,

de Montmollin,

Bouadma

et al. 2023

Current Opinion in Critical Care

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Purpose of review This article aims to provide an updated review on the epidemiology and outcomes of severe meningoencephalitis. Recent findings Meningoencephalitis is a critical medical condition characterized by inflammation in both the meninges and brain parenchyma. Bacterial, viral, or fungal infections are common causes, although noninfectious factors, such as autoimmune causes, can also contribute. In patients requiring intensive care, meningoencephalitis is associated with a severe prognosis, including mortality rates ranging from 11 to 25% and functional disability in 15–25% of survivors. Recent multicenter studies have identified several parameters linked to poor outcomes, including older age, immunocompromised status, focal neurologic signs, abnormal brain imaging, and delayed administration of antimicrobials. The use of new multiplex PCR techniques for diagnosis has generated debate based on recent data. Investigation is still needed to determine the effectiveness of adjunctive therapies, including seizure prophylaxis, and adjunctive steroids for nonbacterial causes. Summary Recent multicenter studies have enhanced our understanding of the current epidemiology and outcomes of severe meningoencephalitis in adult patients.

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Imaging of Central Nervous System Parasitic Infections

Cited by 7 publications

References 85 publications

Infectious Myelopathies

Infectious Myelopathies

Tumor-like Lesions in Primary Angiitis of the Central Nervous System: The Role of Magnetic Resonance Imaging in Differential Diagnosis

Severe meningoencephalitis: epidemiology and outcomes

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