scholarly journals Problems of differential diagnosis of focal brain lesions in patients with HIV infection

2020 ◽  
Vol 12 (1) ◽  
pp. 35-39
Author(s):  
M. Yu. Fomina ◽  
M. A. Titova
Keyword(s):  
Differential Diagnosis ◽  
Hiv Infection ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
B Cell Lymphoma ◽  
Adverse Outcomes ◽  
Cns Lymphoma ◽  
Cerebral Toxoplasmosis ◽  
Therapy Regimen ◽  
Perinatal Hiv

Currently, the leading cause of social disadaptations and disability of patients at advanced stages of HIV infection, as well as adverse outcomes, is the presence of severe comorbid variants of the course of HIV infection: HIV and co-infection of chronic viral hepatitis, tuberculosis, HIV and malignant tumors, and HIV-associated neurological diseases. In pediatric practice, the combination of HIV-induced and perinatal CNS lesions is the most relevant. The differential diagnosis of these conditions is complicated due to the polymorphism of clinical manifestations and the possibility of combining several pathological conditions simultaneously in patients. Neuroimaging data does not always have clear criteria for determining the exact cause of cerebral damage. The article presents data of own clinical neuroimaging observations of two patients with perinatal and parenteral HIV infection. The nervous system damage was polyetiological in nature and was presented in one case by a combination of HIV-encephalitis, cerebral toxoplasmosis and CNS lymphoma, in the second by the presence of Bourneville-Pringle disease (tuberous sclerosis) with the formation of giant-cell astrocytoma and HIV-induced brain damage. It should be noted that the optimization of the antiretroviral therapy regimen in the case of a combination of B-cell lymphoma and cerebral toxoplasmosis in a child with perinatal HIV infection led to clinical and laboratory remission

scholarly journals Blueberry muffin syndrome in a newborn

2020 ◽  
Vol 15 (4) ◽  
pp. 100-104
Author(s):  
M.A. Ufimtseva ◽  
◽  
Yu.M. Bochkarev ◽  
A.U. Sabitov ◽  
K.I. Nikolaeva ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Key Words ◽  
Treatment Initiation ◽  
Neonatal Period ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Intrauterine Infection ◽  
Extramedullary Hematopoiesis ◽  
Timely Treatment ◽  
Torch Infections

We report a case of blueberry muffin syndrome, a rare dermatosis that occurs during the neonatal period. This syndrome is particularly interesting because, despite similar clinical manifestations, it may have various pathological mechanisms and, therefore, requires differential diagnosis. Awareness of doctors of different specialties about clinical manifestations of blueberry muffin syndrome will ensure correct differential diagnosis, timely treatment initiation, no unnecessary therapy, and exclusion of malignant tumors in a child. Key words: neonatal period, blueberry muffin, intrauterine infection of the fetus, TORCH infections, extramedullary hematopoiesis

scholarly journals Stroke in a patient with tuberculous meningitis and HIV infection

2013 ◽  
Vol 5 (1) ◽  
pp. e2013017 ◽  
Author(s):  
Maria Bruna Pasticci ◽  
Maurizio Paciaroni ◽  
Piero Floridi ◽  
Enisia Cecchini ◽  
Franco Baldelli
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Mycobacterium Tuberculosis ◽  
Side Effects ◽  
Hiv Infection ◽  
Tuberculous Meningitis ◽  
Clinical Manifestations ◽  
Treatment Needs ◽  
Caucasian Female ◽  
Meningeal Tuberculosis

Abstract. Tuberculous meningitis (TBM) is a devastating disease. TBM occurs more commonly in HIV infected patients. The influence of HIV co-infection on clinical manifestations and outcome of TBM is not well defined. Yet, some differences have been observed and stroke has been recorded to occur more frequently. This study reports on an HIV infected Caucasian female with lung, meningeal tuberculosis and stroke due to a cortical sub-cortical ischemic lesion.TBM was documented in the absence of neurologic symptoms. At the same time, miliary lung TB caused by multi-susceptible Mycobacterium tuberculosis was diagnosed. Anti-TB therapy consisting of a combination of four drugs was administered. The patient improved and was discharged five weeks later. In conclusion, TBM and multiple underling pathologies including HIV infection, as well as other risk factors can lead to a greater risk of stroke. Moreover, drug interactions and their side effects add levels of complexity. TBM must be included in the differential diagnosis of HIV infected patients with stroke and TBM treatment needs be started as soon as possible before the onset of vasculopathy.

scholarly journals Systemic lupus erythematosus or lupus-like syndrome in patients with HIV infection: clinical case review

2021 ◽  
Vol 2 (1) ◽  
pp. 22-27
Author(s):  
Margarita A. Gromova ◽  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Hiv Infection ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Clinical Manifestations ◽  
High Dose ◽  
Case Review ◽  
Systemic Lupus ◽  
Wide Range

Background. Due to multi-organ lesions and a wide range of clinical manifestations, human immunodeficiency virus (HIV infection) resembles systemic connective tissue diseases, particularly systemic lupus erythematosus (SLE). Similarity of immune disorders in patients with HIV infection and SLE may lead to misdiagnosis resulting in wrong tactics of treatment (prescribing immunosuppressive therapy instead of high-dose antiretroviral therapy). Aim. To report the HIV infection and SLE differential diagnosis challenges. Results. By January 2021, the analysis of national literature revealed two cases of HIV infection in young women, initially misdiagnosed with suspected SLE. In addition to two patients described in literature, one more female patient with SLE manifestations combined with advanced stage of HIV infection was examined. Conclusion. HIV and SLE differential diagnosis is the ultimate challenge for clinicians. Physicians should be especially apprehensive about HIV infection when making the diagnosis of SLE. SLE therapy in patients with HIV infection should be appointed according to strict indications.

scholarly journals Cerebral Toxoplasmosis in a Diffuse Large B Cell Lymphoma Patient

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Lina Savsek ◽  
Tanja Ros Opaskar
Keyword(s):  
Case Report ◽  
B Cell ◽  
Hematological Malignancies ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Toxoplasmic Encephalitis ◽  
Cns Lymphoma ◽  
Cerebral Toxoplasmosis ◽  
Large B Cell Lymphoma ◽  
Large B Cell

AbstractBackground. Toxoplasmosis is an opportunistic protozoal infection that has, until now, probably been an underestimated cause of encephalitis in patients with hematological malignancies, independent of stem cell or bone marrow transplant. T and B cell depleting regimens are probably an important risk factor for reactivation of a latent toxoplasma infection in these patients.Case report. We describe a 62-year-old HIV-negative right-handed Caucasian female with systemic diffuse large B cell lymphoma who presented with sudden onset of high fever, headache, altered mental status, ataxia and findings of pancytopenia, a few days after receiving her final, 8th cycle of rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone (R-CHOP) chemotherapy regimen. A progression of lymphoma to the central nervous system was suspected. MRI of the head revealed multiple on T2 and fluid attenuated inversion recovery (FLAIR) hyperintense parenchymal lesions with mild surrounding edema, located in both cerebral and cerebellar hemispheres that demonstrated moderate gadolinium enhancement. The polymerase chain reaction on cerebrospinal fluid (CSF PCR) was positive for Toxoplasma gondii. The patient was diagnosed with toxoplasmic encephalitis and successfully treated with sulfadiazine, pyrimethamine and folic acid. Due to the need for maintenance therapy with rituximab for lymphoma remission, the patient now continues with secondary prophylaxis of toxoplasmosis.Conclusions. With this case report, we wish to emphasize the need to consider cerebral toxoplasmosis in patients with hematological malignancies on immunosuppressive therapy when presenting with new neurologic deficits. In such patients, there are numerous differential diagnoses for cerebral toxoplasmosis, and the CNS lymphoma is the most difficult among all to distinguish it from. If left untreated, cerebral toxoplasmosis has a high mortality rate; therefore early recognition and treatment are of essential importance.

scholarly journals Effective of antiviral therapy of HIV infection and intercurrent diseases in children

2017 ◽  
Vol 8 (1) ◽  
pp. 50-54
Author(s):  
Vladimir N Timchenko ◽  
Elena B Yastrebova ◽  
Oksana V Bulina
Keyword(s):  
Hiv Infection ◽  
Viral Infections ◽  
Respiratory Infections ◽  
Fungal Infections ◽  
Clinical Manifestations ◽  
Undetectable Viral Load ◽  
Pneumocystis Pneumonia ◽  
Saint Petersburg ◽  
Perinatal Hiv ◽  
Acute Respiratory Diseases

The study included 366 HIV-infected children (under-23) and 350 children with perinatal contact with HIV infection (R-75), consisting on the dispensary account in the Department of motherhood and childhood of the Saint Petersburg city AIDS center. The vast majority of children with perinatal HIV receive HAART (95.0%) with high efficacy (undetectable viral load, normalization of CD4 lymphocytes, the absence of clinical manifestations). In the structure of opportunistic viral infections (herpes, respiratory infections) 40.0%, bacterial (bronchitis, tonsillitis, pyoderma, pulmonary tuberculosis) - 28.6%, fungal infections (candidiasis mucous membranes of the oral cavity) and Pneumocystis pneumonia - 31.4%. Complex therapy (etiotropic, pathogenetic, symptomatic) acute respiratory viral infections in children with B-23 and R-75, allows us to achieve in the early stages (6 days treatment) of the regression of the main symptoms of acute respiratory diseases.

scholarly journals Cerebral Toxoplasmosis in a Diffuse Large B Cell Lymphoma Patient

2014 ◽  
Vol 0 (0) ◽  
Author(s):  
Lina Savsek ◽  
Tanja Ros Opaskar
Keyword(s):  
Case Report ◽  
B Cell ◽  
Hematological Malignancies ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Toxoplasmic Encephalitis ◽  
Cns Lymphoma ◽  
Cerebral Toxoplasmosis ◽  
Large B Cell Lymphoma ◽  
Large B Cell

AbstractBackground. Toxoplasmosis is an opportunistic protozoal infection that has, until now, probably been an underestimated cause of encephalitis in patients with hematological malignancies, independent of stem cell or bone marrow transplant. T and B cell depleting regimens are probably an important risk factor for reactivation of a latent toxoplasma infection in these patients.Case report. We describe a 62-year-old HIV-negative right-handed Caucasian female with systemic diffuse large B cell lymphoma who presented with sudden onset of high fever, headache, altered mental status, ataxia and findings of pancytopenia, a few days after receiving her final, 8th cycle of rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone (R-CHOP) chemotherapy regimen. A progression of lymphoma to the central nervous system was suspected. MRI of the head revealed multiple on T2 and fluid attenuated inversion recovery (FLAIR) hyperintense parenchymal lesions with mild surrounding edema, located in both cerebral and cerebellar hemispheres that demonstrated moderate gadolinium enhancement. The polymerase chain reaction on cerebrospinal fluid (CSF PCR) was positive for Toxoplasma gondii. The patient was diagnosed with toxoplasmic encephalitis and successfully treated with sulfadiazine, pyrimethamine and folic acid. Due to the need for maintenance therapy with rituximab for lymphoma remission, the patient now continues with secondary prophylaxis of toxoplasmosis.Conclusions. With this case report, we wish to emphasize the need to consider cerebral toxoplasmosis in patients with hematological malignancies on immunosuppressive therapy when presenting with new neurologic deficits. In such patients, there are numerous differential diagnoses for cerebral toxoplasmosis, and the CNS lymphoma is the most difficult among all to distinguish it from. If left untreated, cerebral toxoplasmosis has a high mortality rate; therefore early recognition and treatment are of essential importance.

scholarly journals Clinical and prognostic features of cerebral toxoplasmosis in HIV-infected patients in Lubumbashi, Democratic Republic of the Congo

2021 ◽  
Vol 11 (3) ◽  
pp. 79-82
Author(s):  
Joe Kabongo Katabwa ◽  
Olivier Mukuku ◽  
Elie Kabika ◽  
Guy Kandja Lwamba ◽  
Charles Wembonyama Mpoy ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Democratic Republic ◽  
Clinical Manifestations ◽  
Hospital Setting ◽  
Motor Deficit ◽  
Cerebral Toxoplasmosis ◽  
Prognostic Features ◽  
Cell Counts ◽  
Republic Of The Congo ◽  
The Central Nervous System

Introduction: Cerebral toxoplasmosis is the main opportunistic infection of the central nervous system (CNS) during in human immunodeficiency virus (HIV)-infection. The purpose of this study is to describe current epidemiologic, clinical, diagnostic, and prognostic features of cerebral toxoplasmosis during HIV-infection in hospital setting in Lubumbashi. Methods: This descriptive and analytic study examined the records of 21 HIV-positive patients with cerebral toxoplasmosis. Data were collected over 36 months (from January 2015 to December 2017) at the HIV/AIDS Center of Excellence in Lubumbashi (Democratic Republic of the Congo). Results: Twenty-one patients on 4,283 followed for HIV-infection completed the diagnostic criteria (a prevalence of 0.5%) with a sex ratio (M / F) of 1.3 and a mean age of 41.0±6 years. Major clinical manifestations were fever (100%), headaches (100%), motor deficit (61.9%), intracranial hypertension (47.6%), seizures (47.6%), and disorders of consciousness (42.9%). Cerebral imaging studies (4 Computed tomography scan) were performed and showed hypodensities with peripheral enhancement by cockade in 75% of the cases. The mean CD4 T-cell counts was 180.6±161.9 cells / mm3. Co-trimoxazole was the main anti-toxoplasma drug in all cases. The lethality rate was 42.9%. Conclusion: Early detection and primary prevention in HIV-infected patients remain essential to improve the prognosis and survival of these patients.

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