Presentation
These nodules were prominent in the cerebellum, midbrain and medulla and also present in the cortex and thalamus. No coagulative necrosis, necrotizing abscesses, or other opportunistic infections were present. [ncbi.nlm.nih.gov]
This case presented as a mass lesion and had AIDS been in our differential diagnosis, we would have thought of toxoplasmosis. 2. An acute stroke like presentation occurs in a minority of the patients with toxoplasmosis. 3. [neurologyindia.com]
Entire Body System
- Fever
On day +83 he started with fever, and 7 days later tremor, muscular weakness, diplopia, dysarthria, respiratory difficulty, and universal arreflexia appeared, compatible with GBS. [ncbi.nlm.nih.gov]
- Burkina Faso
Polytechnic University, Rue Alwata Diawara, Bobo-Dioulasso, BP 1091, Burkina Faso 3 Radiology and Medical Imaging, Higher Institute of Health Sciences, Polytechnic University, Rue Alwata Diawara, Bobo-Dioulasso, BP 1091, Burkina Faso 4 Department of Infectious [ncbi.nlm.nih.gov]
Eyes
- Diplopia
On day +83 he started with fever, and 7 days later tremor, muscular weakness, diplopia, dysarthria, respiratory difficulty, and universal arreflexia appeared, compatible with GBS. [ncbi.nlm.nih.gov]
Neurologic
- Headache
Abstract Headache and/or migraine, a common problem in pediatrics and internal medicine, affect about 5% to 10% children and adolescents, and nearly 30% of middle-aged women. [ncbi.nlm.nih.gov]
Clinical presentation of cerebral toxoplasmosis in these patients includes headache, focal neurological deficits and seizures. [karger.com]
- Seizure
He had focal seizures for which he was treated as an "epileptic" with herbal preparations. A computerized tomography (CT) head scan revealed the characteristic scan findings in CNS toxoplasmosis. [ncbi.nlm.nih.gov]
Clinical presentation of cerebral toxoplasmosis in these patients includes headache, focal neurological deficits and seizures. [karger.com]
[…] neurological infections in AIDS patients, and is typically observed in the later stages of human immunodeficiency virus (HIV) infection. 1,2 We report the case of a 43-year old man who presented a right necrotic temporal lesion, revealed by epileptic seizure [tmj.ro]
- Confusion
This can confuse the diagnosis and more particularly can confuse therapy since the background dementia will not clear even if parasitic infection is treated. This case is being presented because of the following facts. 1. [neurologyindia.com]
Alteration of consciousness, Karnofsky score less than 70, psychomotor slowing, hemoglobin less than 12 mg/dL, mental confusion, Glasgow Coma Scale less than 12 were the main predictors of partial clinical response. [ncbi.nlm.nih.gov]
Primary CNS Lymphoma (EBV) 30% of all brain lesions in AIDS patients (PML, HIV-associated encephalopathy, and CMV encephalitis usually do not cause mass lesions) History Toxo Headache, confusion, +/- fever; focal weakness, seizures; if advanced, dull [learningradiology.com]
Make sure the airway is protected, especially in confused or obtunded patients. [clinicaladvisor.com]
- Focal Neurological Deficit
Clinical symptoms including fever, headache, changes in mental status and focal neurological deficits were non-specific. [ncbi.nlm.nih.gov]
Clinical manifestations include SEIZURES, altered mentation, headache, focal neurologic deficits, and INTRACRANIAL HYPERTENSION. [connects.catalyst.harvard.edu]
Clinical presentation of cerebral toxoplasmosis in these patients includes headache, focal neurological deficits and seizures. [karger.com]
Clinical manifestations include SEIZURES, altered mentation, headache, focal neurologic deficits, and INTRACRANIAL HYPERTENSION.(From Joynt, Clinical Neurology, 1998, Ch27, pp41-3) [termsciences.fr]
The clinical presentation of CNS toxoplasmosis ranges from headache and fever without neurological symptoms to coma. Typically, the patient presents subacutely with a combination of focal neurological deficits and a non-focal encephalitic component. [neurologyindia.com]
- Ataxia
Cerebral toxoplasmosis or Toxoplasmic encephalitis (TE) in most advance stage HIV infected patients composed of fever, headache, alteration of consciousness with focal neurological signs/symptoms such as include hemiparesis, cranial nerve palsies, and ataxia [clinicaltrials.gov]
There are very rare reports of neurologic IRIS associated with cerebral toxoplasmosis. 3, 4 A 26-year-old woman with HIV-1 infection for 8 years presented with a 1-month history of ataxia, left-sided weakness, and hyperreflexia. [ajnr.org]
[…] mass lesions) History Toxo Headache, confusion, +/- fever; focal weakness, seizures; if advanced, dull affect Lymphoma All of above and constitutional symptoms (night sweats, weight loss) PML Rapid neurologic decline (hemiplegia, visual field defects, ataxia [learningradiology.com]
Due the most frequently localization of encephalitis lesions by Toxoplasma are in the corticalsubcortical binding of the cerebral hemispheres and basal ganglia, contralateral hemiparesis is the most common focal sign followed by ataxia, as was reported [omicsonline.org]
He was apparently doing well on anti retro viral therapy until recently when he began to experience symptoms of ataxia and weakness. Magnetic Resonance Imaging (MRI) of the brain revealed several ring enhancing lesions. [ispub.com]
Workup
An exhaustive diagnostic workup revealed no underlying hematologic disease and no viral infection; a test for autoantibodies had negative results. [jamanetwork.com]
Other Pathologies
- Fibrinoid Necrosis
Severe vasculitis with subsequent thrombosis and extensive fibrinoid necrosis of the vessel wall or direct parasitism of endothelial cells with subsequent destruction and seepage of blood appear to be the possible mechanisms in a situation where the T-cell [ncbi.nlm.nih.gov]
Treatment
CT, 15 patients (3 blood samples collected one day before Toxoplasma gondii treatment; 7 and 15days during the treatment). P/CT, 5 patients (one blood sample collected at least, one year after the treatment). [ncbi.nlm.nih.gov]
Prognosis
In this study, we aimed to characterize the prognosis of patients with HIV infection with severe forms of cerebral toxoplasmosis and to investigate the effects of adjunctive steroids on outcomes. [ncbi.nlm.nih.gov]
Prognosis The prognosis is poor when congenital toxoplasmosis is acquired during the first three months of pregnancy. [medical-dictionary.thefreedictionary.com]
Etiology
For determining etiology, advanced neuroimaging techniques, serological and molecular biological tests have been evolved with varying sensitivities/specificities. [ncbi.nlm.nih.gov]
274 1541 Myohistological Investigations 275 155 Treatment 276 1552 Symptomatic Treatment 277 156 Differential Diagnosis 278 1563 Congenital Fibrosis of the Extraocular Muscles 279 Treatment of Specific Types of Nystagmus 283 161 Introduction 284 16211 Etiology [books.google.com]
However, in many patients, the etiology of subacute meningitis cannot be established [1], [3]. [journals.plos.org]
Epidemiology
Full Text Dear Editor, Highly active antiretroviral therapy (HAART) significantly reduced the cerebral toxoplasmosis incidence in HIV-infected patients from high-income countries. 1 However, there is scarce epidemiological information about this neurological [bjid.org.br]
This chapter presents a review of the biology of this infection including the life cycle, transmission, epidemiology, parasite strains, and the host immune response. [books.google.com]
Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev. 2012; 25 (2): 264-96[ DOI ][ PubMed ] 4. Nissapatorn V, Lee C, Quek KF, Leong CL, Mahmud R, Abdullah KA. Toxoplasmosis in HIV/AIDS patients: a current situation. [archcid.com]
Epidemiology and trend of neurological diseases associated to HIV/AIDS. Experience of Mexican patients 1995-2009. Clin Neurol Neurosurg. 2013 Jan 28. [Medline]. Jones JL, Roberts JM. [emedicine.medscape.com]
Pathophysiology
Currently suggested pathophysiological mechanisms of the disease are mostly derived from stroke cases. Although rare, cerebral toxoplasmosis may strengthen the pathophysiologic mechanism of disease. [ncbi.nlm.nih.gov]
Pathophysiology CNS toxoplasmosis results from infection by the intracellular parasite Toxoplasma gondii. [emedicine.medscape.com]
Prevention
No case of cerebral toxoplasmosis was noted in patients receiving co-trimoxazole in prevention. Presumptive treatment of cerebral toxoplasmosis with co-trimoxazole was effective in all patients with a significant clinical improvement in 83.3%. [ncbi.nlm.nih.gov]
IFNγ can activate microglia, astrocytes, and brain microvascular endothelial cells to prevent tachyzoite growth by using different mechanisms depending on the cell types. [jhu.pure.elsevier.com]
To evaluate the effectiveness of pyrimethamine (given with leucovorin calcium versus placebo (an inactive substance) for the primary prophylaxis (prevention) of cerebral toxoplasmosis in HIV-infected patients. [clinicaltrials.gov]
A.. 2001 ; Preventing opportunistic infections after hematopoietic stem cell transplantation: the Centers for Disease Control and Prevention, Infectious Diseases Society of America, and American Society for Blood and Marrow Transplantation Practice Guidelines [jmmcr.microbiologyresearch.org]