Cerebral Toxoplasmosis in an HIV Patient with Fatal Outcome | Chapter 19 | Highlights on Medicine and Medical Research Vol. 11

 Background: A third of the world's population has latent toxoplasmosis, but 80 percent of cases are asymptomatic. Toxoplasma encephalitis is the most common opportunistic infection in HIV patients, and it is the leading cause of fatal focal brain lesions. Despite increased CD4 counts and lower plasma HIV viral load, clinical deterioration occurs in these patients; this condition is known as Immune Restoration Disease (IRD) or the Immune Reconstitution Inflammatory Syndrome (IRIS). Since the immune system has an irregular inflammatory response during this syndrome, opportunistic infections such as Toxoplasma can reactivate.

The aim in this case was to diagnose the presence of cerebral toxoplasmosis in an HIV-positive paediatric patient.

Mycobacterium tuberculosis culture and polymerase chain reaction were used as methods. Computerized Tomography of the brain, Enzyme Liked Absorbent Assay (ELISA) IgG and IgM, PCR, and Western-Blot were used to diagnose brain toxoplasmosis.

Anti-Toxoplasma antibodies IgM were negative, but IgG tests were positive >300 IU/mL, and Western blots were positive for IgG antibodies. Polymerase Change Reaction revealed that Toxoplasma DNA was negative.

Conclusion: A Neurotoxoplasmosis was indicated by a high level of IgG antibodies confirmed by Western blot and image analyses of Computerized Tomography of the brain.

Author (s) Details

Marcela Espinoza-Oliva
UMAE, Hospital of Pediatrics, Western Medical Center, Mexican Social Security Institute, México.

Erik Severiano Avila
UMAE, Hospital of Pediatrics, Western Medical Center, Mexican Social Security Institute, México.

Maribel Barquera Artega
UMAE, Hospital of Pediatrics, Western Medical Center, Mexican Social Security Institute, México.

Laura Rocío Rodríguez-Pérez
Department of Microbiology and Pathology, University Center for Health Sciences, University of Guadalajara, Jalisco, Mexico.

Laura Verónica Sánchez Orozco
Department of Microbiology and Pathology, University Center for Health Sciences, University of Guadalajara, Jalisco, Mexico.

María de la Luz Galván-Ramírez
Department of Microbiology and Pathology, University Center for Health Sciences, University of Guadalajara, Jalisco, Mexico.

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