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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

(a) Extracellular Toxoplasma tachyzoites (arrow) in the inflamed tissue around the necrosis. (b) Pseudocysts  (arrows); (c) immunocytochemical staining with anti-T. gondii antibodies identifying tachyzoites (arrowhead) and pseudocysts (arrow). (d) At ultrastructural level a parasite within a vacuole in the cell cytoplasm (a, b), H&E.
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fig11: (a) Extracellular Toxoplasma tachyzoites (arrow) in the inflamed tissue around the necrosis. (b) Pseudocysts (arrows); (c) immunocytochemical staining with anti-T. gondii antibodies identifying tachyzoites (arrowhead) and pseudocysts (arrow). (d) At ultrastructural level a parasite within a vacuole in the cell cytoplasm (a, b), H&E.

Mentions: Intracellular and extracellular Toxoplasma tachyzoites (also known as endozoites or trophozoites) and pseudocysts (containing large numbers of bradyzoites, also known as cystozoites), may be easily found with hematoxylin and eosin staining, in the inflamed tissue around the necrosis. Their frequency varies, sometimes abundant, particularly pseudo-cysts, but on occasions are scanty as in treated lesions, when immunocytochemical staining with anti-T. gondii antibodies is useful in identifying parasites. Tachyzoites are oval- or crescent-shaped and measure 2–4 μm. Those within cells may be clustered together (in vacuoles or larger pseudocysts measuring 20–100 μm in diameter) or may appear to lie free in the cell cytoplasm (Figure 11).


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

Chimelli L - Patholog Res Int (2011)

(a) Extracellular Toxoplasma tachyzoites (arrow) in the inflamed tissue around the necrosis. (b) Pseudocysts  (arrows); (c) immunocytochemical staining with anti-T. gondii antibodies identifying tachyzoites (arrowhead) and pseudocysts (arrow). (d) At ultrastructural level a parasite within a vacuole in the cell cytoplasm (a, b), H&E.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig11: (a) Extracellular Toxoplasma tachyzoites (arrow) in the inflamed tissue around the necrosis. (b) Pseudocysts (arrows); (c) immunocytochemical staining with anti-T. gondii antibodies identifying tachyzoites (arrowhead) and pseudocysts (arrow). (d) At ultrastructural level a parasite within a vacuole in the cell cytoplasm (a, b), H&E.
Mentions: Intracellular and extracellular Toxoplasma tachyzoites (also known as endozoites or trophozoites) and pseudocysts (containing large numbers of bradyzoites, also known as cystozoites), may be easily found with hematoxylin and eosin staining, in the inflamed tissue around the necrosis. Their frequency varies, sometimes abundant, particularly pseudo-cysts, but on occasions are scanty as in treated lesions, when immunocytochemical staining with anti-T. gondii antibodies is useful in identifying parasites. Tachyzoites are oval- or crescent-shaped and measure 2–4 μm. Those within cells may be clustered together (in vacuoles or larger pseudocysts measuring 20–100 μm in diameter) or may appear to lie free in the cell cytoplasm (Figure 11).

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