Document Detail


Primary cerebral toxoplasmosis: a rare case of ventriculitis and hydrocephalus in AIDS.
MedLine Citation:
PMID:  15943161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe the clinical, radiological and neuropathological findings in an adult AIDS patient presenting with ventriculitis and hydrocephalus as the primary manifestations of cerebral toxoplasmosis. Clinical symptoms including fever, headache, changes in mental status and focal neurological deficits were non-specific. Cranial computed tomography showed a subtile ventricular dilatation whereas magnetic resonance imaging disclosed triventricular hydrocephalus due to stenosis of the aqueduct and a periventricular nodular rim of high signal intensity on T2- and proton density-weighted images. This rim also showed a slight enhancement on post-contrast T1-weighted images. Focal intracerebral lesions could not be delineated, neither by neuroimaging nor by pathology. Neuropathological examination showed severe ventriculitis with large ependymal and subependymal necrosis as well as dilatation of the lateral and the third ventricle. The only microorganism demonstrated at histology in the central nervous system was Toxoplasma gondii. We conclude that ventriculitis and hydrocephalus without any focal parenchymal lesion may be the only manifestations of CNS toxoplasmosis. It is important to recognize this unusual form of presentation of cerebral toxoplasmosis in order to perform specific therapy.
Authors:
M Sell; R Klingebiel; G Di Iorio; S Sampaolo
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical neuropathology     Volume:  24     ISSN:  0722-5091     ISO Abbreviation:  Clin. Neuropathol.     Publication Date:    2005 May-Jun
Date Detail:
Created Date:  2005-06-09     Completed Date:  2005-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8214420     Medline TA:  Clin Neuropathol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  106-11     Citation Subset:  IM    
Affiliation:
Institute of Pathology, Vivantes Klinikum Neukölln, Charité Campus Mitte, Universitary Medicine, Berlin, Germany. manfredsell@web.de
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / complications,  parasitology,  pathology*
Animals
Anti-Bacterial Agents / therapeutic use
Brain / parasitology,  pathology*,  surgery
Cerebral Ventricles / parasitology,  pathology*,  surgery
Cerebrospinal Fluid Shunts
Encephalitis / parasitology,  pathology*,  therapy
Fatal Outcome
Humans
Hydrocephalus / parasitology,  pathology*,  surgery
Magnetic Resonance Imaging
Male
Middle Aged
Steroids / therapeutic use
Syphilis / complications
Tomography, X-Ray Computed
Toxoplasmosis, Cerebral / complications,  parasitology,  pathology*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Steroids

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