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Pol J Radiol 2023 25;88:e389-e398. Epub 2023 Aug 25.

Department of Radiology, Medical University of Białystok, Białystok, Poland.

Cerebral toxoplasmosis is a parasitic disease resulting, in most cases, from a reactivation of a latent cyst with . The disease mainly affects immunosuppressed individuals, such as HIV (human immunodeficiency virus)-infected patients. Diagnosis is based on specialized antibody testing, clinical symptoms, neuroimaging methods, and histological examination. Read More

Curr Protoc 2023 Sep;3(9):e871

Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA.

Toxoplasma gondii is an obligate intracellular protozoan parasite that commonly infects mammals and birds throughout the world. This protocol describes murine models of acute T. gondii infection, toxoplasmic encephalitis and toxoplasma retinochoroiditis. Read More

Clin Microbiol Infect 2023 Aug 29. Epub 2023 Aug 29.

European Society of Clinical Microbiology and Infectious Diseases, Study Group for Infections of the Brain (ESGIB), Basel, Switzerland; Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Scope: These European Society of Clinical Microbiology and Infectious Diseases guidelines are intended for clinicians involved in diagnosis and treatment of brain abscess in children and adults.

Methods: Key questions were developed, and a systematic review was carried out of all studies published since 1 January 1996, using the search terms 'brain abscess' OR 'cerebral abscess' as Mesh terms or text in electronic databases of PubMed, Embase, and the Cochrane registry. The search was updated on 29 September 2022. Read More

Ann Neurol 2023 Aug 30. Epub 2023 Aug 30.

Neurology Department, Rhode Island Hospital, Brown University, Providence, RI, USA.

IDCases 2023 16;33:e01824. Epub 2023 Jun 16.

Department of Radiology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Central nervous system (CNS) toxoplasmosis is an opportunistic infection caused by the intracellular protozoan parasite . This organism typically causes disease in immunocompromised patients with human immunodeficiency virus (HIV). We reported a case of a 52-year-old woman with neurology symptoms and Magnetic resonance imaging (MRI) brain shows both eccentric and concentric target signs, which are typical signs in a patient with cerebral toxoplasmosis but rarely displayed in the same lesion. Read More

Case Rep Oncol 2023 24;16(1):357-362. Epub 2023 May 24.

Section of Adult Neurology, St. Luke's Medical Center, Institute for Neurosciences, Quezon City, Philippines.

Cerebral toxoplasmosis is an opportunistic infection that, by itself, is difficult to differentiate from cerebral neoplasms by conventional neuroimaging. It rarely occurs concurrently in patients with a primary brain tumor but when it does, it makes diagnosis and management more difficult. This is a case of a 28-year-old female, diagnosed with a right frontal pleomorphic xanthoastrocytoma with several recurrences, treated with surgery, radiation, and chemotherapy. Read More

Open Forum Infect Dis 2023 May 19;10(5):ofad208. Epub 2023 Apr 19.

Critical Care Medicine Department, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland, USA.

Background: Toxoplasmic encephalitis (TE) is a life-threatening complication of people with human immunodeficiency virus (PWH) with severe immunodeficiency, especially those with a CD4 T-cell count <100 cells/µL. Following a clinical response to anti- therapy, and immune reconstitution after initiation of combination antiretroviral therapy (ART), anti- therapy can be discontinued with a low risk of relapse.

Methods: To better understand the evolution of magnetic resonance imaging (MRI)-defined TE lesions in PWH receiving ART, we undertook a retrospective study of PWH initially seen at the National Institutes of Health between 2001 and 2012, who had at least 2 serial MRI scans. Read More

Pathogens 2023 Mar 31;12(4). Epub 2023 Mar 31.

Dr Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA.

Background: Accumulating evidence suggests that toxoplasmosis in immunocompetent hosts can be severe and life-threatening.

Methods: We performed a systematic review of severe toxoplasmosis cases in immunocompetent patients to gain insight into the epidemiology, clinical characteristics, radiological findings, and outcomes of these cases. We classified severe toxoplasmosis as cases with the symptomatic involvement of target organs (the lungs, central nervous system (CNS), and heart), disseminated disease, prolonged disease (>3 months), or a fatal outcome. Read More

Ocul Immunol Inflamm 2023 Apr 21:1-4. Epub 2023 Apr 21.

Uvea Services, Sankara Nethralaya, Chennai, India.

A 30-year-old male presented with sudden painless loss of vision in the right eye for the last two days. Slit-lamp examination of the right eye revealed a quiet anterior chamber and anterior vitreous. Fundus examination of the right eye revealed a large, focal retinitis lesion centered around the fovea, whereas examination of the left was unremarkable. Read More

Surg Neurol Int 2023 10;14:82. Epub 2023 Mar 10.

Department of Neurosurgery, Azienda Ospedaliera Universitaria di Sassari, Via Enrico De Nicola, Sassari, Italy.

Background: Cerebral toxoplasmosis is a relatively rare disorder that usually affects immunocompromised patients. The most common scenario occurs among human immunodeficiency virus (HIV)-positive patients. In those patients, toxoplasmosis is the most frequent cause of expansive brain lesion and continues to cause elevated morbidity and mortality. Read More

Prenat Diagn 2022 Dec 21;42(13):1674-1681. Epub 2022 Nov 21.

Ob-Gyn Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Fetal cerebral ventriculomegaly is a relatively common finding, observed during approximately 1% of obstetric ultrasounds. In the second and third trimester, mild (≥10 mm) and severe ventriculomegaly (≥15 mm) are defined according to the measurement of distal lateral ventricles that is included in the routine sonographic examination of central nervous system. A detailed neurosonography and anatomy ultrasound should be performed to detect other associated anomalies in the central nervous system and in other systems, respectively. Read More

JAMA Netw Open 2022 Nov 1;5(11):e2239796. Epub 2022 Nov 1.

Neuroscience and Mental Health Program, SickKids Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada.

Importance: Very preterm neonates (24-32 weeks' gestation) remain at a higher risk of morbidity and neurodevelopmental adversity throughout their lifespan. Because the extent of prematurity alone does not fully explain the risk of adverse neonatal brain growth or neurodevelopmental outcomes, there is a need for neonatal biomarkers to help estimate these risks in this population.

Objectives: To characterize the pediatric buccal epigenetic (PedBE) clock-a recently developed tool to measure biological aging-among very preterm neonates and to assess its association with the extent of prematurity, neonatal comorbidities, neonatal brain growth, and neurodevelopmental outcomes at 18 months of age. Read More

Epidemiol Mikrobiol Imunol 2022 ;71(3):165-170

Objective: To report on a unique combination of cerebral toxoplasmosis and ocular toxoplasmosis in an HIV-positive patient in Slovakia.

Methods: A 35-year-old heterosexual patient who presented with headache and major seizures underwent computed tomography (CT) and magnetic resonance imaging (MRI). Based on clinical findings, serological tests for toxoplasmosis were performed on serum and ocular fluid specimens. Read More

North Clin Istanb 2022 11;9(3):282-285. Epub 2022 May 11.

Department of Hematology, Erciyes University Faculty of Medicine, Kayseri, Turkiye.

Cerebral toxoplasmosis is a rare but often life-threatening infection after hematopoietic stem cell transplantation (HSCT). In such cases, early diagnosis and initiation of treatment are vital. We describe a case of cerebral toxoplasmosis in a patient who underwent HSCT for acute myeloid leukemia. Read More

Surg Neurol Int 2022 12;13:354. Epub 2022 Aug 12.

Neurosurgery, John A. Burns School of Medicine, Honolulu, Hawaii, United States.

Background: Cerebral toxoplasmosis is an opportunistic infection in patients but has rarely been described in the setting of compromised humoral immunodeficiency. Prompt diagnosis and treatment of the infection is critical in the care of these patients. Medical management is the mainstay of treatment of the infection. Read More

AIDS Res Ther 2022 Sep 8;19(1):40. Epub 2022 Sep 8.

Division of Infectious Diseases, Chongqing Public Health Medical Center, 109 Baoyu Road, Shapingba District, Chongqing, 400036, China.

Background: Patients with acquired immunodeficiency syndrome (AIDS) tend to suffer from several central nervous system (CNS) infections due to hypoimmunity. However, CNS aspergillosis (CNSAG) is extremely rare and difficult to diagnose. Thus, it is easily misdiagnosed. Read More

Healthcare (Basel) 2022 Aug 7;10(8). Epub 2022 Aug 7.

Department of Infectious Diseases and Hepatology, Medical University Wroclaw, 50-367 Wroclaw, Poland.

: Central nervous system (CNS) disorders are estimated to occur in approximately 10-20% of people living with HIV (PLWH). They are more commonly observed in newly diagnosed patients and in previously untreated patients or those refusing to undergo antiretroviral treatment. CNS diseases can also be the first manifestation of HIV/AIDS infection. Read More

Brain Sci 2022 Aug 8;12(8). Epub 2022 Aug 8.

Department of Neurosurgery, Hospital de São José, 1150-199 Lisbon, Portugal.

Toxoplasmosis is one of the most common opportunistic infections, mainly reported in patients with acquired immunodeficiency syndrome (AIDS). Patients with rheumatoid arthritis (RA) have also been linked to reactivation of toxoplasmosis due to immunosuppressive treatment, although biologic drugs have seldom been implicated. We present a case of cerebral toxoplasmosis in a 62-year-old female patient with RA after initiation of biologic therapy (adalimumab). Read More

Indian J Pathol Microbiol 2022 ;65(3):649-652

Department of Pathology and Laboratory Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

We report a patient who developed reactivated toxoplasmic encephalitis due to human immunodeficiency (HIV)-associated immune compromise, resulting in a breakdown of the balance between the host immunity and toxoplasma cyst. Through detailed pathological analysis, spilling of tachyzoites from the ruptured wall of toxoplasma cyst can be identified. It was also proved that Toxoplasma gondii would infect endothelial cells of blood vessels, leading to vasculitis and brain ischemic necrosis. Read More

J Clin Med 2022 Jun 10;11(12). Epub 2022 Jun 10.

Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany.

The utilization of fluorescein-guided biopsies has recently been discussed to improve and expedite operative techniques in the detection of tumor-positive tissue, as well as to avoid making sampling errors. In this study, we aimed to report our experience with fluorescein-guided biopsies and elucidate distribution patterns in different histopathological diagnoses in order to develop strategies to increase the efficiency and accuracy of this technique. We report on 45 fluorescence-guided stereotactic biopsies in 44 patients (15 female, 29 male) at our institution from March 2016 to March 2021, including 25 frame-based stereotactic biopsies and 20 frameless image-guided biopsies using VarioGuide. Read More

Cureus 2022 May 8;14(5):e24827. Epub 2022 May 8.

Internal Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, IND.

Central nervous system (CNS) toxoplasmosis is one of the common causes of hemorrhagic brain lesions in people living with HIV and AIDS (PLWHA), resulting in high mortality and morbidity. It has a broad clinical and neuro-radiological spectrum, which may or may not be limited to typical findings of focal and subacute neurological deficits or ring-enhancing lesions in the basal ganglia. Here, we present a case of a patient who is a newly detected person living with HIV and AIDS with a low CD cell count and classical imaging findings of central nervous system toxoplasmosis on his magnetic resonance imaging (MRI) of the brain. Read More

Surg Neurol Int 2022 6;13:191. Epub 2022 May 6.

Department of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, United States.

Background: Cerebral toxoplasmosis is a rare complication of relapsed/refractory multiple myeloma (MM) after autologous stem cell transplant (SCT). Imaging characteristics can be helpful in leading to rapid diagnosis and treatment.

Case Description: A 76-year-old man with relapsed/refractory IgA kappa MM status post autologous SCT who presented to the hospital with altered mental status. Read More

Am J Case Rep 2022 May 25;23:e936257. Epub 2022 May 25.

Department of Neurology, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia.

BACKGROUND The iceberg phenomenon (in which the most of a problem is invisible) of people living with HIV/AIDS, particularly those with unknown HIV status, has been epidemiologically challenging. Central nervous system (CNS) opportunistic infections in patients with HIV/AIDS are one of the leading causes of morbidity and mortality in people living with HIV/AIDS. There are currently limited data on the immunogenicity, safety, and efficacy of COVID-19 vaccines in people living with HIV/AIDS with its associated opportunistic CNS infections as well as those without antiretroviral treatment. Read More

Korean J Parasitol 2022 Feb 23;60(1):35-38. Epub 2022 Feb 23.

Department of Neurosurgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul 07061, Korea.

Cerebral toxoplasmosis is often life-threatening in an immunocompromised patient due to delayed diagnosis and treatment. Several differential diagnoses could be possible only with preoperative brain images of cerebral toxoplasmosis which show multiple rim-enhancing lesions. Due to the rarity of cerebral toxoplasmosis cases in Korea, the diagnosis and treatment are often delayed. Read More

J Med Case Rep 2022 Feb 15;16(1):62. Epub 2022 Feb 15.

Department of infectious Diseases Q, Odense University Hospital, Odense, Denmark.

Background: Human immunodeficiency virus-1-associated neurocognitive disorder is a known complication in individuals treated with antiretroviral therapy. Cerebrospinal fluid escape, which is defined as discordant higher cerebrospinal fluid viremia than plasma, may occur in antiretroviral therapy-experienced individuals. Different cerebrospinal fluid versus plasma mutation patterns have been observed in individuals with cerebrospinal fluid escape. Read More

Surg Neurol Int 2022 20;13:25. Epub 2022 Jan 20.

Department of Neurosurgery, Neurological Institute, Houston Methodist Hospital, Houston, Texas, United States.

Background: Secondary central nervous system lymphoma may manifest in a variety of ways on imaging, but most commonly presents with leptomeningeal disease, isolated parenchymal lesions, or both. We present a case of secondary central nervous system T-cell lymphoma with miliary pattern of spread noted on imaging.

Case Description: Our patient had known systemic T-cell lymphoma involving the gastrointestinal and respiratory tracts and underwent stereotactic biopsy confirming secondary cerebral metastasis. Read More

Rev Peru Med Exp Salud Publica 2021 20;38(3):463-466. Epub 2021 Dec 20.

Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú.

Cerebral nocardia infections is a rare entity, which has been mainly reported in immunosuppressed patients. Currently, there are no clinical guidelines for first-line treatment. Our case refers to an older immunocompetent adult, with encephalopathy and left hemiparesis, associated with lesions compatible with multiple brain abscess and suggestive of infectious etiology. Read More

Sleep Sci 2021 ;14(Spec 1):94-96

Universidade Federal de São Paulo, Departamento de Psicobiologia - São Paulo - Brazil.

Introduction: We describe a case of sleep state misperception in a patient with a neurotoxoplasmosis lesion in the left nucleocapsular region.

Case Report: A 40-year-old female patient presented relating sleeplessness over the past 2 years, concurrent with progressive headaches, dizziness and motor and sensory deficits in the right upper and lower limbs. She had a history of AIDS, on irregular antiretroviral therapy and neurotoxoplasmosis. Read More

Brain Sci 2021 Oct 28;11(11). Epub 2021 Oct 28.

Department of Neurosurgery, 10th Military Research Hospital and Polyclinic, 85-681 Bydgoszcz, Poland.

Stereotactic biopsy of posterior fossa lesions is often regarded as hazardous due to the critical structures in that area. Therefore, the aim of the study was to evaluate the diagnostic accuracy and safety of infratentorial stereotactic biopsy of brainstem or cerebellar lesions and its associations with other clinical, laboratory, and radiological parameters. From January 2000 to May 2021, 190 infratentorial stereotactic biopsies of posterior fossa tumors, including 108 biopsies of brainstem lesions, were performed. Read More

BMJ Case Rep 2021 Oct 27;14(10). Epub 2021 Oct 27.

Microbiology, Indraprastha Apollo Hospital, New Delhi, India.

Cerebral phaeohyphomycosis refers to central nervous system infection by dematiaceous mould or by dark walled fungi which contain the dark pigment melanin in their cell wall which adds to the virulence of fungus. These dematiaceous fungi can cause a variety of central nervous infections including invasive sinusitis, brain abscess, meningitis, myelitis and arachnoiditis. among these dematiaceous fungi is the most common cause of brain abscess in immunocompetent and immunocompromised individuals and is known to occur worldwide though is predominantly reported from subtropical regions especially the Asian subcontinent. Read More