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Neurocysticercosis and HIV infection: report of two cases and review
J L Soto Hernandez1, L Ostrosky Zeichner, G Tavera
1Infectious Diseases Department and Neurosurgery Division, National Institute of Neurology and Neurosurgery, Mexico City, Mexico.
Background:
With the progression of acquired immunodeficiency virus (AIDS) and human immunodeficiency virus (HIV) infection to endemic areas of cysticercosis, the simultaneous diagnosis of both diseases is an expected event.
Methods:
Among 91 patients with AIDS or HIV infection studied from 1987 to 1993 at a neurologic reference center in Mexico City, 2 patients with AIDS and neurocysticercosis were found. Five previously reported cases were jointly reviewed.
Results:
The first patient presented with increased intracranial pressure of rapid progression. A single giant cyst was surgically excised and cysticercus was confirmed on histopathologic examination. The second patient had brain toxoplasmosis and concurrent neurocysticercosis as an incidental finding.
Conclusions:
Neurocysticercosis in HIV infection/AIDS may appear as a life-threatening condition or as an incidental finding. All reported cases have been found in advanced stages of HIV infection. Management must be individualized depending on the clinical form of cysticercosis, stage of HIV infection, and coexisting opportunistic conditions. Surgery may be lifesaving and some patients apparently responded to cysticidal drugs.