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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. Chronic, treated, cystic lesions containing macrophages in the cerebellum (a) and periventricular regions (b).
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Related In: Results  -  Collection


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fig12: Toxoplasmosis. Chronic, treated, cystic lesions containing macrophages in the cerebellum (a) and periventricular regions (b).

Mentions: In chronic, treated lesions, the central area of coagulative necrosis is well demarcated, may become cystic, containing macrophages (Figure 12), and surrounded by microglial nodules and reactive astrocytes. Organisms are scanty or absent and immunostaining may or may not identify residual antigen in these lesions. Healed or end-stage (burnt out) lesions, when tissue reaction is no longer available, are common presentation nowadays, particularly in countries where the treatment is effective. With the antiretroviral therapy some lesions are associated with the IRIS.


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

Chimelli L - Patholog Res Int (2011)

Toxoplasmosis. Chronic, treated, cystic lesions containing macrophages in the cerebellum (a) and periventricular regions (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig12: Toxoplasmosis. Chronic, treated, cystic lesions containing macrophages in the cerebellum (a) and periventricular regions (b).
Mentions: In chronic, treated lesions, the central area of coagulative necrosis is well demarcated, may become cystic, containing macrophages (Figure 12), and surrounded by microglial nodules and reactive astrocytes. Organisms are scanty or absent and immunostaining may or may not identify residual antigen in these lesions. Healed or end-stage (burnt out) lesions, when tissue reaction is no longer available, are common presentation nowadays, particularly in countries where the treatment is effective. With the antiretroviral therapy some lesions are associated with the IRIS.

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