Ramón CCJ, Sancho SA, Gimeno PMJ

Language: Spanish
References: 8
Page: 79-82
PDF size: 174.17 Kb.

ABSTRACT

Introduction: Cerebral toxoplasmosis is one of the most common opportunistic infections in HIV patients, being the main cause of brain lesions in this population, causing important neurological sequelae and reaching a high mortality rate in this group of patients. Clinical case: A female patient came to the emergency department with fever, headache, nausea, and left upper limb paresis with no known relevant medical history. Laboratory studies reveal decreased CD4+ levels and positive serologies for HIV. It was studied with the use of complementary methods. CT and MRI showed images compatible with infection for toxoplasmosis. Serology was performed for the parasite that was positive, giving the definitive diagnosis. He was treated with pyrimethamine-sulfadiazine for a six-weeks. Conclusion: Cerebral toxoplasmosis is frequent in patients with HIV, so an early diagnosis of both HIV and toxoplasmosis is essential for adequate treatment, avoiding future comorbidities.

REFERENCES

1. Dunay IR, Gajurel K, Dhakal R, Liesenfeld O, Montoya JG. Treatment of toxoplasmosis: historical perspective, animal models, and current clinical practice. Clin Microbiol Rev. 2018; 31 (4): e00057-17. doi: 10.1128/CMR.00057-17.

2. Vidal JE. HIV-related cerebral toxoplasmosis revisited: current concepts and controversies of an old disease. J Int Assoc Provid AIDS Care. 2019; 18: 2325958219867315. doi: 10.1177/2325958219867315.

3. Lyons RE, McLeod R, Roberts CW. Toxoplasma gondii tachyzoite-bradyzoite interconversion. Trends Parasitol. 2002; 18 (5): 198-201. doi: 10.1016/S1471-4922(02)02248-1.

4. Parlog A, Schluter D, Dunay IR. Toxoplasma gondii-induced neuronal alterations. Parasite Immunol. 2015; 37 (3): 159-170.

5. Mamidi A, DeSimone JA, Pomerantz RJ. Central nervous system infections in individuals with HIV-1 infection. J Neurovirol. 2002; 8 (3): 158-167. doi: 10.1080/13550280290049723.

6. Hernandez AV, Thota P, Pellegrino D, Pasupuleti V, Benites-Zapata VA, Deshpande A et al. A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option? HIV Med. 2017; 18 (2): 115-124.

7. Selby JV, Friedman GD, Quesenberry CP Jr, Weiss NS. A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med. 1992; 326 (10): 653-657.

8. Greenway MRF, Sacco KA, Burton MC. In deep: cerebral toxoplasmosis. Am J Med. 2017; 130 (7): 802-804.