Toxoplasma encephalitis in Haitian adults with acquired immunodeficiency syndrome: a clinical-pathologic-CT correlation
The clinical data, histologic findings, and computed tomographic (CT) abnormalities in eight adult Haitians with toxoplasma encephalitis were analyzed retrospectively. Diagnosis was established by identification of Toxoplasma gondii on autopsy in five and brain biopsy in three specimens and subsequently confirmed by the immunoperoxidase method. All these patiens, six of whom had been in the United States for 24 months or less, had severe idiopathic immunodeficiency syndrome. All were lymphopenic and six were on treatment for tuberculosis when the toxoplasma encephalitis developed. All patients were studied with CT when they developed an altered mental status and fever associated with seizures and/or focal neurologic deficits. Scans before treatment showed multiple intraparenchymal lesions in seven and a single lesion in the thalamus in one. Ring and/or nodular enhancement of the lesions was found in six and hypodense areas in two. Progressions of abnormalities occurred on serial studies. These CT findings that were best shown on axial and coronal thin-section double-dose contrast studies were useful but not diagnostically pathognomonic. In patients with similar clinical presentation CT is recommended to identify focal areas of involvement and to guide brain biopsy or excision so that prompt medical thereapy of this often lethal infection can be instituted.
- Research Organization:
- Univ. of Miami School of Medicine, FL
- OSTI ID:
- 5441338
- Journal Information:
- AJR, Am. J. Roentgenol.; (United States), Vol. 140:5
- Country of Publication:
- United States
- Language:
- English
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59 BASIC BIOLOGICAL SCIENCES
BRAIN
COMPUTERIZED TOMOGRAPHY
ENCEPHALITIS
PATHOLOGY
HEMIC DISEASES
ADULTS
AUTOPSY
HAITI
HISTOLOGY
IMMUNITY
PROTOZOA
THALAMUS
AGE GROUPS
ANIMALS
BODY
CENTRAL NERVOUS SYSTEM
DIAGNOSTIC TECHNIQUES
DISEASES
GREATER ANTILLES
HISPANIOLA
INFECTIOUS DISEASES
INVERTEBRATES
ISLANDS
MICROORGANISMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
ORGANS
TOMOGRAPHY
VIRAL DISEASES
WEST INDIES
550602* - Medicine- External Radiation in Diagnostics- (1980-)
550900 - Pathology