A case series of cerebral toxoplasmosis in the practice of a neurological hospital

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Abstract

Introduction. Central nervous system is one of the main targets in patients with HIV infection. Neurological complications in AIDS are primarily caused by opportunistic brain infections including toxoplasmosis as the most common one. Patients with cerebral toxoplasmosis are often hospitalized with diagnosed strokes, tumors, or encephalitis. At that, their HIV status may be unknown and their state severity often does not allow conducting the range of required examinations.

Materials and methods. We have described our experience in management of 6 patients admitted to the neurosurgery department with single toxoplasmosis foci and diagnosed brain tumors.

Results. HIV infection was initially known in 3 patients only. In 2 compensated patients, the diagnosis was confirmed via Toxoplasma IgG blood test. In 2 individuals, negative serological Toxoplasma reactions were followed by neuronavigationally controlled biopsies. A patient with an extensive perifocal edema and, as a result, dislocated midline structures underwent decompressive craniectomy and mass removal. One female patient, with an unclear diagnosis, was operated for a suspected brain tumor. After additional assessments (including 4 histologies to confirm cerebral toxoplasmosis), all the patients were transferred to the infectious disease hospital for specific treatment.

About the authors

Pavel G. Shnyakin

Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical Hospital

Author for correspondence.
Email: shnyakinpavel@mail.ru
ORCID iD: 0000-0001-6321-4557
ResearcherId: AAI-8384-2020

D. Sci. (Med.), Associated Professor, Head, Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky; Head, Regional Cardiovascular Diseases Center, Regional Clinical Hospital

Russian Federation, Krasnoyarsk; Krasnoyarsk

Anton V. Botov

Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical Hospital

Email: Doktor_anton@rambler.ru
ORCID iD: 0000-0001-6393-0430

Cand. Sci. (Med.), Assistant, Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky; Head, Neurosurgical Department No. 2, Regional Clinical Hospital

Russian Federation, Krasnoyarsk; Krasnoyarsk

Pavel G. Rudenko

Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical Hospital

Email: rpg30@rambler.ru
ORCID iD: 0000-0003-3756-1445

Cand. Sci. (Med.), Assistant, Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky; Neurosurgeon, Neurosurgical Department No. 1, Regional Clinical Hospital

Russian Federation, Krasnoyarsk; Krasnoyarsk

Vladimir A. Khorzhevsky

Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical Hospital

Email: vladpatholog@yandex.ru
ORCID iD: 0000-0002-9196-7246

Cand. Sci. (Med.), Head, Pathological Anatomy Department named after Prof. P.G. Podzolkov, Krasnoyarsk State Medical University named after Prof. V.F. Voino-Yasenetsky; Deputy Head for Pathological and Anatomical Work, Regional Clinical Hospital

Russian Federation, Krasnoyarsk; Krasnoyarsk

Irirna S. Usatova

Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky; Regional Clinical Hospital

Email: irinausatova01@mail.ru
ORCID iD: 0000-0001-6813-8776

ассистент каф. травматологии, ортопедии и нейрохирургии с курсом ПО ФГБОУ ВО КрасГМУ им. проф. В.Ф. Войно-Ясенецкого; врач-нейрохирург нейрохирургического отделения № 2 КГБУЗ «Краевая клиническая больница»

Russian Federation, Krasnoyarsk; Krasnoyarsk

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2. Fig. 1. Contrast-enhanced brain MSCT image of patient Ya.

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3. Fig. 2. Сontrast-enhanced brain MSCT image of patient R. at admission.

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4. Fig. 3. Contrast-enhanced brain MSCT image one month postoperatively.

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5. Fig. 4. Т2 weighed (А, В) and FLAIR (С) brain MRI images of female patient R. one month postoperatively.

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6. Fig. 5. Female patient R.'s brain bioptate.

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Copyright (c) 2023 Shnyakin P.G., Botov A.V., Rudenko P.G., Khorzhevsky V.A., Usatova I.S.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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