Escárcega-Rincón LA, Juárez-Hernández F, Pensado-Piedra L,Sotelo-Robledo R, Martínez-Gallardo S, Rodríguez-Rodríguez M, Vega-Barrientos RS

Language: Spanish
References: 13
Page: 147-153
PDF size: 360.27 Kb.

ABSTRACT

Purpose. Identify the most common tomographic findings of neuroinfection in HIV-positive patients, as well as the most common etiologic agents and the importance of tomography in detecting such alterations.
Material and methods. Fifty-six clinical and x-ray files of HIVpositive patients registered in the period between January 2007 and December 2011 at the National Institute of Respiratory Diseases were reviewed. Only 30 patients who had a confirmed diagnosis of both HIV and neuroinfection, as well as contrasted cranial tomography and study of cephalorachidian fluid (CRF), were included. CD4 concentrations in patients with no tomographic finding of neuroinfection and patients who presented tomographic alteration were compared using the Kruskal-Wallis test.
Results. Contrasted cranial tomography in the patients studied in this sample produced findings compatible with meningitis in 46.6% of the cases; in this group, mycobacterium tuberculosis was identified as the most common causal agent (69%). In the statistical analysis of different CD4 values no statistically significant difference was found.
Conclusions. Cranial tomography is a highly valuable method, with good sensitivity and excellent availability for studying patients with HIV and signs of neuroinfection. The most common tomographic findings were suggestive of meningitis and mycobacterium tuberculosis was the most common causal agent in patients in our population.

REFERENCES

1. Smith AB, Smirniotopoulos J, Rushing E. Central Nervous, System Infections Associated With Human Inmunodeficiency Virus Infection: Radiologic-Pathologyc Correlation, Radiographics 2008;28:2033-2058.

2. Thwaites G, Chau TH, Drobniewski F, Mc Adam K, Farrar J. Tuberculosis Meningitis. JNNP 2000;68:289-299.

3. Bicanic T, Harrison T, Cyrptococcal Meningitis. British Medical Bulletin 2004;72:99-118.

4. Munive M. Neurosifilis Caso Clínico y Revisión Bibliográfica. Revista Médica de Costa Rica y Centro América 2009;987:95-103.

5. Medina MI, Quiñones JA. Accidentes Cerebrovasculares y Neuroinfeccion: Guía Neurológica 8 ed, Asociación Colombiana de Neurología 2010;15:243-260.

6. Dres M, Salamano R. Leucoencefalopatía multifocal progresiva: a propósito de un caso clínico-patológico en un paciente infectado por VIH. Rev Med Uruguay 2003;19:78-82.

7. Teo YK. Cryptococcal Meningoencephalitis With Fulminant Intracranial Hypertension: An Unespected Cause of Brain Death. SMJ 2010;51(8):133.

8. Wilhem JP, BS Barry A, Siegel A, Everette A. Brain Scanning and Cisternography in Criptococcosis, Radiology 1973;109:121-124.

9. Balakrishnan J, Bekker PS, Kumar A, Zinreich S, McArthur J, Nick Bryan R. Acquired Inmunodeficiency Syndrome Correlation of radiologic and pathologic findings in the brain. Radiographics 1990;10:201-215.

10. Harisinghani M, Mcloud TC, Shepard O, Ko J, Shroff M, Mueller P. Tuberculosis From Head to Toe. Radiographics 2000;20:449-470.

11. Seow WT, Yeo TT. Tuberculoma of the Brain Report of two cases and Review of the Literature. SMJ 1991;32:427-430.

12. Ng SW, Lam MS, Paton NI. Cryptococcal Meningitis Resulting in Irreversible Visual Imperment in AIDS Patients a report of two cases. Singapore Med J 2000;41:80-2.

13. Engin G, Acunas B, Acunas G, Tunaci M. Imaging of Extrapulmonary Tuberculosis. Radiographics 2000;20:471-488.