medigraphic.com
ISSN 1561-3186 (Electronic)

2013, Number 1

<< Back Next >>

Rev Acta Médica 2013; 14 (1)

Imaging patterns in patients with neurotoxoplasmosis associated to HIV/AIDS

Peña CA, Rodríguez RDF, Aguilar CMC, de la Paz BT, Pérez NJ, Valls PO

Language: Spanish
References: 21
Page:
PDF size: 52.47 Kb.


ABSTRACT

A study was conducted to characterize cephalic lesions found in patients with neurotoxoplasmosis associated to HIV/AIDS. The sample was composed of 53 patients who were referred to «Hermanos Ameijeiras» Hospital to undergo neuroimaging studies. Sociodemographic, clinical, anatomical and imaging variables were used to characterize, compare and group the lesions according to presentation patterns and to issue an imaging diagnostic impression. Neurotoxoplasmosis affected 30 cases (56 %), with multiple lesions in 21 patients (70 %). The most frequent anatomic locations were the basal nuclei, the thalamus and the parietal lobes. Presence of perilesional edema in the magnetic resonance imaging (MRI) was evidenced in the 100 % of the cases. The CT- scan was more sensible to identify cerebral calcifications. The 96.7 % of the cases presented contrast enhancement after IV contrast administration for the CT-scan. An imaging pattern of focal lesion with contrast enhancement is a key for the diagnosis of Neurotoxoplasmosis, generally confirmed with specific treatment response.


REFERENCES

  1. Scaravilli F, Bazille C, Gray F. Neuropathologic contributions to understanding AIDS and the central nervous system. Brain Pathol. 2007;17(2):197-208.

  2. Levy RM, Mills CM, Posin JP, Moore SG, Rosenblum ML, Bredesen DE. The efficacy and clinical impact of brain imaging in neurologically symptomatic AIDS patients: a prospective CT/MRI study. J Acquir Immune Defic Syndr. 1990;3(5):461-71.

  3. Cornford ME, Holden JK, Boyd MC, Berry K, Vinters HV. Neuropathology of the acquired immune deficiency syndrome (AIDS): report of 39 autopsies from Vancouver, Br Columbia. Can J Neurol Sci. 1992;19(4):442-52.

  4. Oropesa G, Sánchez V, Berdasquera D, Gala A, Pérez J, Lantero M. Debut clínico de sida en Cuba. Rev Cubana Med Trop. 2007;59:2.

  5. Nogueira S, Guedes A, Machado E, Matos J, Costa T, Cortes E, et al. Toxoplasmic encephalitis in an HIV infected pregnant woman: successful outcome for both mother and child. Braz J Infect Dis. 2002;6(4):102-3.

  6. Miranda G, Díaz C, Dellien H, Hermosilla H. Enfrentamiento imaginológico de las lesiones cerebrales en pacientes VIH. Rev Chilena Radiol. 2008;14:200-7.

  7. Smith A, Smirniotopoulos J, Rushing E. Central nervous system infections associated with human immunodeficiency virus infection: Radiologic pathologic correlation. Radio Graphics. 2008;28:2033-58.

  8. Trenkwalder P, Trenkwalder C, Feiden W, Vogl TJ, Einhaupl KM, Lydtin H. Toxoplasmosis with early intracerebral hemorrhage in a patient with the acquired immunodeficiency syndrome. Neurology. 1992;42(2):43-68.

  9. Fischbein NJ, Dillon WP, Barkovich AJ. Teaching atlas of brain imaging. New York, NY: Thieme; 2000.

  10. Mantilla J, Cárdenas N. Hallazgos neuropatológicos de la infección por VIH-SIDA: estudio de auptosias en el hospital universitario de Santander, Bucaramanga, Colombia. Colomb Med. 2009;40(4).

  11. Koller K. Neoplasias del sistema nerviosos central y masas de apariencia tumoral en: Brant W, Helms C, Fundamentos de radiología diagnóstica, Lippincott Williams & Wilkis. Philadelphia; 2008. p. 122-155.

  12. Hung-jen T, Yung-Ching L, Muh-Young Y, Yao-Shen C, Shue-Ren W, His-Hsun L, et al. Opportunistics infections in adults with acquired immunodeficiency síndrome: a comparison of clinical and autopsy findings. J Microbiol Immunol Infect. 2006;39:310- 5.

  13. Ferreira Moreno V, Martí Coruña M, Rufín Arregoitía A, González Hernández G. Neuroimagen en el SIDA. Rev méd electrón [Seriada en línea] 2007 [consulta 30 Jun 2011];29(2). Disponible en:http://www.cpimtz.sld.cu/revista%20medica/año%202007 /vols2%202007/tema19.htm

  14. Sibtain NA, Chinn R. Imaging of the central nervous system in HIV infection. Imaging. 2002;14:48-59.

  15. Fransi L, Aguado C. Guias clínicas VIH/SIDA [homepage en internet] [consulta 29 Jun 2011]. Disponible en: http://www.fisterra.com

  16. Joint United Programme on VIH/SIDA (UNAIDS) /World Health Organization (WHO). Guidelines for effective use of data from HIV surveillance systems; 2010.

  17. García J, Pinedo A, Escalza I. Complicaciones neurológicas de la infección por el virus de la inmunodeficiencia humana. Neurología. 2007;22(5):312-9.

  18. Colombo FA, Vidal JE, Penalva de Oliveira AC. Diagnosis of cerebral toxoplasmosis in AIDS patients in Brazil: importance of molecular and immunological methods using peripheral blood samples. J Clin Microbiol. 2005;43(10):504-47.

  19. Castaño J, Sánchez G, Franco D, Gonzales M, Giraldo A. Determinación de las características clínico epidemiológicas de la neuroinfección en pacientes con diangnóstico de VIH/sida en el departamento de Quindio. Rev Infect Col. 2007;11:4.

  20. Barreiro L. Utilidad de la TAC y la RM en el diagnóstico de la neurotoxoplasmosis en pacientes VIH/sida [tesis]. La Habana: Hospital Clínico Quirúrgico "Hermanos Ameijeiras"; 2007.

  21. McArthur JC, Brew B. Nath A. Neurological complications of HIV infections. Lacent Neurol. 2005;4:543-5.




2020     |     www.medigraphic.com