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- Title
Toxoplasma gondii meningoencephalitis without cerebral MRI findings in a patient with ulcerative colitis under immunosuppressive treatment.
- Authors
Assimakopoulos, S.; Stamouli, V.; Dimitropoulou, D.; Spiliopoulou, A.; Panos, G.; Anastassiou, E.; Marangos, M.; Spiliopoulou, I.
- Abstract
Toxoplasmosis is the most common opportunistic infection of the central nervous system in immunosupressed patients. It is usually presented as a space-occupying lesion detected by cerebral computerized tomography or magnetic resonance imaging. The diffuse form of the disease (diffuse toxoplasmic meningoencephalitis) lacks the characteristic cerebral radiologic findings rendering pre-mortem diagnosis much more difficult. Herein, we describe a case of toxoplasmic menincoencephalitis, without evidence of cerebral space-occupying lesions, in a patient with ulcerative colitis under combined therapy with systemic glucocorticoids and azathioprine. Diagnosis was based on microscopic examination of cerebrospinal fluid (CSF) for the parasite, whereas, RT-PCR for Toxoplasma gondii was negative. Taking into consideration the limitations of molecular methods, investigation of the etiology of meningeal involvement in patients under immunosuppressive therapy presenting positive serology of previous T. gondii infection, should include microscopic examination of CSF for parasite presence.
- Subjects
CEREBROSPINAL fluid examination; MENINGOENCEPHALITIS; CEREBRAL toxoplasmosis; IMMUNOSUPPRESSION; MICROSCOPY; POLYMERASE chain reaction; REVERSE transcriptase polymerase chain reaction; DIAGNOSIS
- Publication
Infection, 2015, Vol 43, Issue 5, p589
- ISSN
0300-8126
- Publication type
Report
- DOI
10.1007/s15010-015-0730-9