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A morphological approach to the diagnosis of protozoal infections of the central nervous system.

Chimelli L - Patholog Res Int (2011)

Bottom Line: In addition, immunosuppression associated with various conditions, particularly with HIV infection, favors the occurrence of more severe manifestations and failure to respond to treatments.Predominant presentations are meningoencephalitis (trypanosomiasis), encephalopathy (cerebral malaria), or as single or multiple pseudotumoral enhancing lesions (toxoplasmosis, reactivated Chagas' disease).The immune reconstitution disease, resulting from enhancement of pathogen-specific immune responses after HAART, has altered the typical presentation of toxoplasmosis and microsporidiosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University Hospital, Federal University of Rio de Janeiro, 21941-913 Rio de Janeiro, RJ, Brazil.

ABSTRACT
Protozoal infections, though endemic to certain regions, can be seen all around the world, because of the increase in travel and migration. In addition, immunosuppression associated with various conditions, particularly with HIV infection, favors the occurrence of more severe manifestations and failure to respond to treatments. The CNS may be the only affected system; when not, it is often the most severely affected. Despite information obtained from clinical, laboratory, and imaging procedures that help to narrow the differential diagnosis of intracranial infections, there are cases that need confirmation with biopsy or autopsy. Predominant presentations are meningoencephalitis (trypanosomiasis), encephalopathy (cerebral malaria), or as single or multiple pseudotumoral enhancing lesions (toxoplasmosis, reactivated Chagas' disease). The immune reconstitution disease, resulting from enhancement of pathogen-specific immune responses after HAART, has altered the typical presentation of toxoplasmosis and microsporidiosis. In this paper, a morphological approach for the diagnosis of protozoal infections affecting the CNS (amoebiasis, cerebral malaria, toxoplasmosis, trypanosomiasis, and microsporidiosis) is presented.

No MeSH data available.


Related in: MedlinePlus

Toxoplasmosis: mass lesions in the right occipital lobe and cerebellar vermis.
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Related In: Results  -  Collection


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fig8: Toxoplasmosis: mass lesions in the right occipital lobe and cerebellar vermis.

Mentions: The brain contains multifocal single or multiple necrotizing space-occupying lesions of variable sizes. The mass lesions can be located both above and below the tentorium (Figure 8). The basal ganglia and the gray-white matter cortical junctions are often involved, but any part of the brain may be affected. There may be associated hemorrhage. Older lesions are cystic due to resorption of necrotic material (Figure 9). Occasionally brain involvement results in an encephalitic process without obvious focal lesions on macroscopic examination [2, 16].


A morphological approach to the diagnosis of protozoal infections of the central nervous system.

Chimelli L - Patholog Res Int (2011)

Toxoplasmosis: mass lesions in the right occipital lobe and cerebellar vermis.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3140201&req=5

fig8: Toxoplasmosis: mass lesions in the right occipital lobe and cerebellar vermis.
Mentions: The brain contains multifocal single or multiple necrotizing space-occupying lesions of variable sizes. The mass lesions can be located both above and below the tentorium (Figure 8). The basal ganglia and the gray-white matter cortical junctions are often involved, but any part of the brain may be affected. There may be associated hemorrhage. Older lesions are cystic due to resorption of necrotic material (Figure 9). Occasionally brain involvement results in an encephalitic process without obvious focal lesions on macroscopic examination [2, 16].

Bottom Line: In addition, immunosuppression associated with various conditions, particularly with HIV infection, favors the occurrence of more severe manifestations and failure to respond to treatments.Predominant presentations are meningoencephalitis (trypanosomiasis), encephalopathy (cerebral malaria), or as single or multiple pseudotumoral enhancing lesions (toxoplasmosis, reactivated Chagas' disease).The immune reconstitution disease, resulting from enhancement of pathogen-specific immune responses after HAART, has altered the typical presentation of toxoplasmosis and microsporidiosis.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, University Hospital, Federal University of Rio de Janeiro, 21941-913 Rio de Janeiro, RJ, Brazil.

ABSTRACT
Protozoal infections, though endemic to certain regions, can be seen all around the world, because of the increase in travel and migration. In addition, immunosuppression associated with various conditions, particularly with HIV infection, favors the occurrence of more severe manifestations and failure to respond to treatments. The CNS may be the only affected system; when not, it is often the most severely affected. Despite information obtained from clinical, laboratory, and imaging procedures that help to narrow the differential diagnosis of intracranial infections, there are cases that need confirmation with biopsy or autopsy. Predominant presentations are meningoencephalitis (trypanosomiasis), encephalopathy (cerebral malaria), or as single or multiple pseudotumoral enhancing lesions (toxoplasmosis, reactivated Chagas' disease). The immune reconstitution disease, resulting from enhancement of pathogen-specific immune responses after HAART, has altered the typical presentation of toxoplasmosis and microsporidiosis. In this paper, a morphological approach for the diagnosis of protozoal infections affecting the CNS (amoebiasis, cerebral malaria, toxoplasmosis, trypanosomiasis, and microsporidiosis) is presented.

No MeSH data available.


Related in: MedlinePlus