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3-D Imaging and Analysis of Neurons Infected In Vivo with Toxoplasma gondii
Published on: December 9, 2014
Severe cerebral toxoplasma infection cannot be excluded by a normal CT scan
J J Weenink1, A G Weenink, S E Geerlings
1Department of Internal Medicine, Renal Transplant Unit, Center for Infection and Immunity Amsterdam (CINIMA), Academic Medical Centre, Amsterdam, the Netherlands. jweenink@tsz.nl
The Netherlands Journal of Medicine
|July 14, 2009
Summary
In immunocompromised patients, cerebral toxoplasmosis can be fatal. Magnetic resonance imaging (MRI) is crucial for diagnosing brain toxoplasmosis when computed tomography (CT) scans are normal.
Area of Science:
- Neurology
- Infectious Diseases
- Transplant Medicine
Background:
- Severely immunocompromised individuals, such as renal transplant recipients, are at high risk for opportunistic infections.
- Cerebral toxoplasmosis is a serious opportunistic infection affecting the brain.
Observation:
- A 50-year-old female renal transplant recipient presented with fever and confusion.
- Initial contrast-enhanced computed tomography (CT) scans of the brain revealed no abnormalities.
- Subsequent magnetic resonance imaging (MRI) demonstrated clear abnormalities in the basal ganglia.
Findings:
- Diagnosis of cerebral toxoplasmosis was confirmed by serology and polymerase chain reaction (PCR).
- Cerebral CT scans can appear normal in cases of cerebral toxoplasmosis.
- MRI provided critical additional diagnostic information when CT was inconclusive.
Implications:
- Empirical treatment for cerebral toxoplasmosis should be initiated promptly in at-risk patients with suspected symptoms, even before definitive diagnostic confirmation.
- Negative results from serology and PCR tests for toxoplasmosis should be interpreted cautiously due to suboptimal sensitivity.
- MRI is a valuable tool for detecting cerebral toxoplasmosis when CT scans are non-diagnostic, especially in immunocompromised patients.
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