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cerebral toxoplasmosis non hiv

Dieta Brandsma, Jacoline E C Bromberg
Primary CNS lymphoma (PCNSL) has been designated an acquired immune deficiency syndrome (AIDS)-defining disease since 1983 and accounts for up to 15% of non-Hodgkin lymphomas in human immunodeficiency virus (HIV) patients. The majority of HIV patients are Epstein-Barr virus (EBV)-related. The most likely etiology is ineffective immunoregulation of EBV, inducing oncogenic protein expression, and subsequent loss of apoptosis and increased proliferation of lymphocytes. PCNSL generally presents with supratentorial, single or multiple, contrast-enhancing lesions...
2018: Handbook of Clinical Neurology
Rita Rb-Silva, Claudia Nobrega, Eugénia Reiriz, Soraia Almeida, Rui Sarmento-Castro, Margarida Correia-Neves, Ana Horta
BACKGROUND: HIV-infected patients may present an unforeseen clinical worsening after initiating antiretroviral therapy known as immune reconstitution inflammatory syndrome (IRIS). This syndrome is characterized by a heightened inflammatory response toward infectious or non-infectious triggers, and it may affect different organs. Diagnosis of IRIS involving the central nervous system (CNS-IRIS) is challenging due to heterogeneous manifestations, absence of biomarkers to identify this condition, risk of long-term sequelae and high mortality...
January 13, 2017: BMC Infectious Diseases
N Elenga, M T Ggeorger-Sow, T Messiaen, I Lamaury, I Favre, M Nacher, G Beaucaire
The aim of this study was to investigate the mortality rate, risk factors and causes of death among HIV-infected patients in Guadeloupe from 1988 to 2009. We used Kaplan-Meier analysis to describe the survival trends and the Cox proportional hazard model to identify predictors of deaths in HIV-infected patients. Mortality rate and causes of death were compared among patients whose HIV diagnosis was made in two different study periods. There were 672 deaths recorded. The exact cause of death was clearly identified for 202 patients (35%)...
September 18, 2015: West Indian Medical Journal
Diana Murro, Jorge Novo, Leonidas Arvanitis
Classic cerebral toxoplasmosis typically presents with neurologic symptoms such as seizures and mental status changes and histological examination shows focal lesions with necrosis. However, in the diffuse "encephalitic" form, patients are asymptomatic with diffuse, inflammatory, non-necrotic lesions. Asymptomatic diffuse "encephalitic" toxoplasmosis has been reported only in four acquired immunodeficiency syndrome patients and one human immunodeficiency virus (HIV) negative patient with chronic lymphocytic leukemia...
July 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ryan Mattie, Zack McCormick, Henry Huie
Toxoplasma gondii is an opportunistic infection that often presents in the setting of acquired immunodeficiency syndrome. The infection can cause severe and potentially fatal encephalitis because of the reactivation of latent infections in the setting of immune suppression. Diagnosing toxoplasmosis encephalitis (TE) in immunocompromised patients often is difficult because the signs and symptoms can be nonspecific, but making a diagnosis of TE is even more challenging in a patient who is not known to have human immunodeficiency virus/acquired immunodeficiency syndrome and shows no other signs of being immunocompromised...
June 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Poojary Indira, Papanna Mohan Kumar, Shenoy Shalini, Kulkarni Vaman
BACKGROUND: HIV/AIDS and Diabetes Mellitus are the diseases' known to supress cell mediated immunity and predispose patients for opportunistic infections. Hence, we conducted a study to compare the common opportunistic infections (OIs) between People Living with HIV with DM (PLHIV-DM) and PLHIV without DM (PLHIV). METHODOLOGY: PLHIV with DM and without DM (1:1) were prospectively included in the study from January 2011 to January 2012 at a tertiary care hospital in Mangalore city...
2015: PloS One
Liliana Jazmín Cortés, Sofía Duque, Miryam Consuelo López, Diego Moncada, Diego Molina, Jorge Enrique Gómez-Marín, María Luz Gunturiz
INTRODUCTION: There are no reports describing polymorphisms in target genes of anti- Toxoplasma drugs in South American isolates. OBJECTIVE: This study sought to perform cloning and sequencing of the dihydrofolate reductase ( dhfr ) and dihydropteroate-synthase ( dhps ) genes of the reference Rh strain and two Colombian isolates of Toxoplasma gondii . MATERIALS AND METHODS: Two isolates were obtained from the cerebrospinal fluid of HIV-infected patients with cerebral toxoplasmosis...
October 2014: Biomédica: Revista del Instituto Nacional de Salud
Rama Prosad Goswami, Rudra Prosad Goswami, Mehebubar Rahman, Yogiraj Ray, Santanu Kumar Tripathi
The current standard treatment for cerebral toxoplasmosis (pyrimethamine/sulfadiazine) often encounters problems of poor tolerability, adverse effects, frequent dropouts and non-availability of pyrimethamine/sulfadiazine in some parts of India. We have had to use the combination of two effective alternative agents for toxoplasmosis, cotrimoxazole and clindamycin, on compassionate grounds. This retrospective observational study reports superior efficacy and better tolerability of cotrimoxazole/clindamycin compared to the recommended regimen...
October 2015: International Journal of STD & AIDS
O'Dene Lewis, Babak Shokrani, Doshi Saumil, Marc Phillpotts
SESSION TITLE: Infectious Disease Student/Resident Case Report Posters IIISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Toxoplasmosis is the most common parasitic opportunistic infection of the central nervous system (CNS) in AIDS patients who are not on appropriate prophylaxis. Extra-cerebral sites may be involved with or without CNS toxoplasmosis. Pulmonary involvement is uncommon but is second to the CNS as the major site of disease...
October 1, 2014: Chest
Margarida Matias, Antonia Gomes, Tiago Marques, Ana Claudia Fonseca
A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye. The ophthalmological examination revealed hypertensive non-granulomatous panuveitis, retinal vasculitis with focus of retinochoroiditis with pigmented central area suggestive of ocular toxoplasmosis in the active phase. He started treatment with azithromycin, pyrimethamine, topical steroids and measures for control of intraocular pressure. Serology for Toxoplasma gondii was positive and for HIV, negative...
September 30, 2014: BMJ Case Reports
François Barbier, Antoine Roux, Emmanuel Canet, Patricia Martel-Samb, Philippe Aegerter, Michel Wolff, Bertrand Guidet, Elie Azoulay
PURPOSE: Multicentre data are limited to appraise the management and prognosis of critically ill human immunodeficiency virus (HIV)-infected patients. We sought to describe temporal trends in demographic and clinical characteristics, indications for intensive care and outcome in this patient population. METHODS: We conducted a cohort study of unselected HIV-infected patients admitted between 1999 and 2010 to 34 French ICUs contributing to the CUB-Réa prospective database...
December 2014: Intensive Care Medicine
Zhi Hua Li, Fu You Guo, Zhong Quan Wang, Jing Cui
Toxoplasmosis is a serous parasitic zoonosis caused by the protozoan Toxoplasma gondii worldwide. Human beings acquire the disease by eating infected meat containing T. gondii cysts, by ingesting water or vegetables contaminated with oocysts shed in the feces of an infected cat, and by transmission from mother to fetus. Cerebral toxoplasmosis is one of the most serious complications in immunocompromised individuals such as HIV-infected patients, with a high mortality rate, whereas the incidence of cerebral toxoplasmosis is extremely rare in immunocompetent persons...
July 2014: Pathogens and Global Health
Kosuke Yasukawa, Shital M Patel, Charlene A Flash, Charles E Stager, Jerry C Goodman, Laila Woc-Colburn
As a result of global migration, a significant number of people with Trypanosoma cruzi infection now live in the United States, Canada, many countries in Europe, and other non-endemic countries. Trypanosoma cruzi meningoencephalitis is a rare cause of ring-enhancing lesions in patients with acquired immunodeficiency syndrome (AIDS) that can closely mimic central nervous system (CNS) toxoplasmosis. We report a case of CNS Chagas reactivation in an AIDS patient successfully treated with benznidazole and antiretroviral therapy in the United States...
July 2014: American Journal of Tropical Medicine and Hygiene
Charlotte Lewden, Youssoufou J Drabo, Djimon M Zannou, Moussa Y Maiga, Daouda K Minta, Papa S Sow, Jocelyn Akakpo, François Dabis, Serge P Eholié
OBJECTIVE: We aimed to describe the morbidity and mortality patterns in HIV-positive adults hospitalized in West Africa. METHOD: We conducted a six-month prospective multicentre survey within the IeDEA West Africa collaboration in six adult medical wards of teaching hospitals in Abidjan, Ouagadougou, Cotonou, Dakar and Bamako. From April to October 2010, all newly hospitalized HIV-positive patients were eligible. Baseline and follow-up information until hospital discharge was recorded using standardized forms...
2014: Journal of the International AIDS Society
A M Traoré, D K Minta, M Fomba, H Cissé, K Diallo, I Coulibaly, A Soukho-Kaya, S A Beye, T Cissé, M Dembélé, H A Traoré, E Bissagnené
We conduct a longitudinal descriptive study in the department of infectious diseases to CHU of Point G during 18 months. It concerned adult patients referred from another care center. All the patients underwent systematic clinical examination and complementary exploration. Our sample was 352 HIV+ patients, with a mean age of 37.8 ± 9.8 years and a sex ratio (M/F)=0.94 shared among patients receiving ARV treatment (ART-s) and not (n-ART). Delay of reference was 5 ± 4.4 days. All patients benefited from clinical and paraclinical examinations...
February 2014: Bulletin de la Société de Pathologie Exotique
Catherine S Marshall, Andrea J Curtis, Tim Spelman, Daniel P O'Brien, Jane Greig, Leslie Shanks, Philipp du Cros, Esther C Casas, Marcio Silveira da Fonseca, Eugene Athan, Julian H Elliott
OBJECTIVES: To identify associations between specific WHO stage 3 and 4 conditions diagnosed after ART initiation and all cause mortality for patients in resource-limited settings (RLS). DESIGN, SETTING: Analysis of routine program data collected prospectively from 25 programs in eight countries between 2002 and 2010. SUBJECTS, PARTICIPANTS: 36,664 study participants with median ART follow-up of 1.26 years (IQR 0.55-2.27). OUTCOME MEASURES: Using a proportional hazards model we identified factors associated with mortality, including the occurrence of specific WHO clinical stage 3 and 4 conditions during the 6-months following ART initiation...
2013: PloS One
Cristina S Meira, José E Vidal, Thais A Costa-Silva, Gabriela Motoie, Ricardo Gava, Roberto M Hiramoto, Vera L Pereira-Chioccola
Cerebral toxoplasmosis is the most common neurological opportunistic disease manifested in HIV infected patients. Excretory/secretory antigens (ESA) are serological markers for the diagnosis of reactivation of the infection in HIV-infected patients with cerebral toxoplasmosis. Immunosuppressed patients develop high antibody titers for ESA. However, little is known about the humoral response for these antigens. The present study analyzed the profile of antibody recognition against ESA in comparison with tachyzoite lysate antigen (TLA) in 265 sera and 270 cerebrospinal fluid (CSF) samples from infected patients with Toxoplasma gondii and or HIV and in sera of 50 healthy individuals...
September 30, 2013: Journal of Immunological Methods
Mj Lee, M Rayment, A Scourfield, B Gazzard
OBJECTIVES: We aimed to identify the factors associated with developing AIDS 6 months or more after an HIV diagnosis, and to examine how post-HIV diagnosis AIDS (PHDA) patients differed from true late presenters (HIV diagnosed concurrent with the first AIDS presenting event) in their demographics and comorbidities. METHODS: A retrospective analysis was undertaken of all inpatients admitted to a large HIV unit presenting with the following AIDS-defining infections: cryptococcal meningitis, cerebral toxoplasmosis or Pneumocystis jirovecii pneumonia between 1 January 2005 and 31 December 2010...
November 2013: Sexually Transmitted Infections
Thomas D Westwood, Celia Hogan, Peter J Julyan, Glyn Coutts, Suzie Bonington, Bernadette Carrington, Ben Taylor, Saye Khoo, Alec Bonington
BACKGROUND AND PURPOSE: In HIV infected patients, MRI cannot reliably differentiate between central nervous system (CNS) lymphoma and non-malignant CNS lesions, particularly cerebral toxoplasmosis (CTOX). This study prospectively investigates the utility of FDG PET-CT and magnetic resonance spectroscopy (MRS) in discriminating CNS lymphoma from non-malignant CNS lesions in HIV infected patients, and assesses the ability of FDG PET-CT to guide the use of early brain biopsy. METHODS: 10 HIV patients with neurological symptoms and contrast enhancing lesions on MRI were commenced on anti-toxoplasmosis therapy before undergoing FDG PET-CT and MRS...
August 2013: European Journal of Radiology
Yoshiharu Miura, Shuji Kishida
Human immunodeficiency virus (HIV) induces acquired immunodeficiency syndrome (AIDS) in humans. Neurological complications occur frequently in patients with AIDS. About 20 to 40% of all these patients develop neurological symptoms, and in about 10% of AIDS patients, the onset of the disease is characterized by neurological symptoms. These may be related to primary HIV infection or to any of a large number of opportunistic viral and non-viral infections. HIV itself induces acute HIV aseptic meningitis, HIV-1-associated neurocognitive disorder (HAND), HIV distal sensory polyneuropathy, and HIV vacuolar myelopathy...
March 2013: Brain and Nerve, Shinkei Kenkyū No Shinpo
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