Toxoplasma encephalitis and AIDS in a patient with seizure and altered mental status: A case report

Valadkhani, Somayeh; Radmard, Amir Reza; Saeedi, Morteza; Nikpour, Shahriar; Farnia, Mohammad Reza

doi:10.5847/wjem.j.1920-8642.2017.01.012

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…Toxoplasmosis can cause severe clinical symptoms and even death in infants, pregnant women and immunocompromised individuals [ 2 , 3 ]. This parasite can infect all host tissues, but the central nervous system and muscles are the predilection sites [ 4 ]. Tachyzoites of T. gondii can invade almost all nucleated cells but have a particular affinity for nerve cells, resulting in T. gondii encephalitis [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Unveiling of brain transcriptome of masked palm civet (Paguma larvata) with chronic infection of Toxoplasma gondii

et al. 2022

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Background The aim of this study was to gain an understanding of the transcriptomic changes that occur in a wild species when infected with Toxoplasma gondii. The masked palm civet, an artifically domesticated animal, was used as the model of a wild species. Transcriptome analysis was used to study alterations in gene expression in the domesticated masked palm civet after chronic infection with T. gondii. Methods Masked palm civets were infected with 105 T. gondii cysts and their brain tissue collected after 4 months of infection. RNA sequencing (RNA-Seq) was used to gain insight into the spectrum of genes that were differentially expressed due to infection. Quantitative reverse-transcription PCR (qRT-PCR) was also used to validate the level of expression of a set of differentially expressed genes (DEGs) obtained by sequencing. Results DEGs were screened from the sequencing results and analyzed. A total of 2808 DEGs were detected, of which 860 were upregulated and 1948 were downregulated. RNA-Seq results were confirmed by qRT-PCR. DEGs were mainly enriched in cellular process and metabolic process based on gene ontology enrichment analysis. Kyoto Encyclopedia of Genes and Genomes pathway analysis showed that transcriptional changes in the brain of infected masked palm civets evolved over the course of infection and that DEGs were mainly enriched in the signal transduction, immune system processes, transport and catabolic pathways. Finally, 10 essential driving genes were identified from the immune signaling pathway. Conclusions This study revealed novel host genes which may provide target genes for the development of new therapeutics and detection methods for T. gondii infection in wild animals. Graphical Abstract

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Section: Introductionmentioning

confidence: 99%

Unveiling of brain transcriptome of masked palm civet (Paguma larvata) with chronic infection of Toxoplasma gondii

et al. 2022

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“…In antiviral therapy, non-nucleoside reverse transcriptase inhibitors nevirapine and efavirenz can cause severe skin eruption. [10,11] Anti-tuberculosis drugs are the second most common cause of drug-induced erythroderma in our study. It is suggested that AIDS patients should be tested for tuberculosis infection early, and skin changes should be closely observed during the course of anti-tuberculosis treatment.…”

Section: Discussionmentioning

confidence: 73%

“…It has been reported that the drug eruption rate in HIV-positive patients is 100 times that of HIVnegative patients. [10][11][12] However, AIDS patients with drug-induced erythroderma is rare, and the mechanism is still unclear. [13] Common agents that cause druginduced erythroderma in HIV-negative persons include carbamazepine antiepileptic drugs, sulfa antibiotics, penicillins, and cephalosporins.…”

Section: Discussionmentioning

confidence: 99%

Drug-induced erythroderma in patients with acquired immunodeficiency syndrome

Zhu¹,

Fang²,

Fang³

2021

World Journal of Emergency Medicine

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BACKGROUND: To explore the clinical manifestations, diagnosis, and treatment of patients with acquired immunodefi ciency syndrome (AIDS) complicated with drug-induced erythroderma. METHODS:The clinical data of 12 AIDS patients with drug-induced erythroderma in our hospital were retrospectively analyzed. The general information, offending medications, complications, modified severity-of-illness score for toxic epidermal necrolysis (SCORTEN) scores, and disease outcome spectrums were analyzed.RESULTS: Drug-induced erythroderma was mostly caused by antiviral drugs, antituberculosis drugs, antibiotics, traditional Chinese medicine, and immune checkpoint inhibitors. The spectrum of sensitizing drugs was broad, the clinical situation was complex, and infections were common. The affected areas were greater than 40% body surface area in all patients. The modified SCOTERN score averaged 3.01±0.99. All patients were treated with glucocorticoids, and nine patients were treated with intravenous immunoglobulin (IVIG) pulse therapy at the same time. The average time to effectiveness was 7.08±2.23 days, and the average hospital stay was 17.92±8.46 days. Eleven patients were cured, and one patient died of secondary multiple infections, who had a modified SCORTEN score of 5 points. The mortality rate in this study was 8.3%. CONCLUSIONS:The clinical situation of AIDS patients with drug-induced erythroderma in hospitalized patients is complex and the co-infection rate is high. The use of modified SCORTEN score may objectively and accurately assess the conditions, and the use of glucocorticoid combined with IVIG therapy may improve the prognosis.

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“…If seropositive without evidence of active toxoplasma encephalitis and a CD4 of <100µL, it is recommended to initiate prophylactic TMP-SMX. Prophylaxis/secondary prophylaxis may be discontinued with response to ART by an increase in CD4 + counts to >200 cells/µL for >3 months [9]. Of note ruling out G6PD deficiency should be done prior to initiation of treatment given association with severe hemolytic anemia.…”

Section: Discussionmentioning

confidence: 99%

Anisocoria, An Unusual Physical Exam Finding Leading to a Concurrent Diagnosis of Cerebral Toxoplasmosis and HIV/AIDS

Vante¹,

Matheus²

2021

J Infect Dis Case Rep

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Cerebral toxoplasmosis is the most common opportunistic central nervous system (CNS) infection, affecting patients with advanced/untreated acquired immunodeficiency syndrome (AIDS). Cerebral toxoplasmosis is caused by the parasite Toxoplasma gondii typically and it usually occurs in immunecompromised patients with a CD4 count below 100cell/microL [1,2]. Left untreated, symptomatic patients can progress to coma within days to weeks, significantly increasing rates of this population’s morbidity and mortality. Cerebral toxoplasmosis is rarely encountered before the diagnosis of HIV infection is established, which is why seemingly benign neurological complaints can be easily overlooked.

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Toxoplasma encephalitis and AIDS in a patient with seizure and altered mental status: A case report

Cited by 5 publications

References 6 publications

Unveiling of brain transcriptome of masked palm civet (Paguma larvata) with chronic infection of Toxoplasma gondii

Unveiling of brain transcriptome of masked palm civet (Paguma larvata) with chronic infection of Toxoplasma gondii

Drug-induced erythroderma in patients with acquired immunodeficiency syndrome

Anisocoria, An Unusual Physical Exam Finding Leading to a Concurrent Diagnosis of Cerebral Toxoplasmosis and HIV/AIDS

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