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2011, Number 2

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Rev Med MD 2011; 2.3 (2)

Toxoplasma encephalitis masqueraded by chemotherapy for nonhodgkin lymphoma in a VIH infected patient

Álvarez-Villanueva M, Ontiveros-Mercado H
Full text How to cite this article

Language: Spanish
References: 8
Page: 128-131
PDF size: 509.60 Kb.


Key words:

Acquired Immune Deficiency Syndrome, CD20, Non – Hodgking Lymphoma, stereotactic biopsy, Toxoplasma gondii.

ABSTRACT

43 year old male, diagnosed with Acquired Immune Deficiency Syndrome and diffuselarge B-cell non-Hodgkin lymphoma affecting lungs and Central Nervous System, (CNS) goes through three chemotherapy cycles and intrathecalcytarabine showing partial recovery. Two weeks forward to treatment shows frank central nervous system deterioration. Cranial Magnetic Resonance Imaging (MRI) is performed, which depicts cerebellum and peduncle lesions. Stereotactic biopsy reports proliferative lesions compatible with Non – Hodgkin Lymphoma and the presence of Toxoplasma gondii. NHL occurs in 3 - 4% of HIV infected patients, mainly the B – cell line and it mostly affects liver, gastro intestinal system and central nervous system. Toxoplasma encephalitis comes the majority of times as a result of a reactivation of a latent infection by the HIV virus and a CD4+ lymphocyte level < 200 cels/µ L and is the main cause of focal brain lesions in patients with AIDS.


REFERENCES

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  2. Ammassari A, Cingolani A, Pezzotti P, De Luc A, Murri R, Giancola M.L., et al. AIDS-related focal brain lesions in the era of highly active antiretroviral therapy. Neurology. 2000. 55(8):1194-1200.

  3. Smego RA, Orlovic D, Wadula J. An algorithmic approach to intracranial mass lesions in HIV/AIDS. Int J STD AIDS. 2006. 17: 271–276.

  4. Herold MA, Kühne R, et al. Disseminated Toxoplasmosis in a Patient with Non-Hodgkin Lymphoma. Infection. 2009. 37: 551–554.

  5. Bacchu S, Fegan C, Neal J. Cerebral toxoplasmosis in a patient with chronic lymphocytic leukaemia treated with fludarabine. Br J Haematol. 2007. 139:349.

  6. Lenz G, Staudt L. M. Agressive Lymphomas. N Engl J Med. 2010. 362:1417-1429.

  7. Salemi M, Lamers S.L., Huysentruyt L.C., Galligan D, Gray R.R, Morris A, et al. Distinct Patterns of HIV-1 Evolution within Metastatic Tissues in Patients with Non-Hodgkins Lymphoma. PLoS ONE. 2009. 4(12)

  8. Béraud G, Pierre-Francois S, et al. Cotrimoxazole for Treatment of Cerebral Toxoplasmosis: An Observational Cohort Study during 1994–2006. Am J Trop Med Hyg. 2009. 80 (4): 583-587.




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Rev Med MD. 2011;2.3