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[Toxoplasma encephalitis with atypical manifestation and normal CT]
T L Katzenstein1, S Oster, K Kiss
1Københavns Universitet, Neuropatologisk Institut, H:S Rigshospitalet.
Ugeskrift for Laeger
|August 6, 1998
Summary
Cerebral toxoplasmosis can present unusually in HIV-positive individuals, even with normal CT scans. Early consideration and empirical treatment are vital for patients with neurological symptoms.
Area of Science:
- Neurology
- Infectious Diseases
- Immunology
Background:
- Cerebral toxoplasmosis is a significant opportunistic infection in Human Immunodeficiency Virus (HIV)-positive individuals.
- Typical presentations involve focal neurological deficits, but atypical and diffuse symptoms can occur.
Observation:
- A case of cerebral toxoplasmosis in an HIV-positive man is presented with atypical clinical manifestations.
- Computed Tomographic (CT) scanning results were normal, highlighting a diagnostic challenge.
Findings:
- The absence of antitoxoplasma antibodies and normal CT findings do not rule out toxoplasma encephalitis.
- Magnetic Resonance Imaging (MRI) offers higher sensitivity than CT for diagnosing cerebral toxoplasmosis.
Implications:
- Cerebral toxoplasmosis can be deceptive in HIV-positive patients, necessitating a high index of suspicion.
- Empirical therapy should be considered broadly for HIV-positive patients presenting with neurological symptoms.