Okubo Yoichiro, Shinozaki Minoru, Yoshizawa Sadako, Nakayama Haruo, Wakayama Megumi, Hatori Tsutomu, Mituda Aki, Hirano Takayuki, Shimodaira Kayoko, Yuzhu Zhi, Shibuya Kazutoshi
Department of Surgical Pathology, Toho University School of Medicine, 6-11-1 Omori-Nishi, Ota-Ku, Tokyo, 143-8541, Japan.
J Med Case Rep. 2010 Aug 11;4:265. doi: 10.1186/1752-1947-4-265.
Toxoplasmosis can be a life-threatening disease when it occurs in patients with HIV infection. In particular, meningioencephalitis has been regarded as the most common toxoplasmic complication in such patients. However, toxoplasmic meningitis in a patient with HIV infection is extremely rare and purulent or tuberculous meningitis should be considered initially as a disease for differential diagnosis in Japan.
Toxoplasmic meningitis in a patient with HIV infection is reported. A 36-year-old Japanese man presented with fever, pulsating headache, lumbago, nausea, and vomiting. No examinations suggested toxoplasmosis including cerebrospinal fluid examinations, images, and serological tests. The result of a polymerase chain reaction assay using paraffin-embedded section was regarded as the conclusive evidence for the diagnosis.
We wish to emphasize the usefulness of polymerase chain reaction assays with nucleic acid extracted from paraffin-embedded tissue sections processed for routine histopathological examination, if the section shows the infectious agents or findings suggesting some infectious diseases.
弓形虫病在HIV感染患者中发生时可能是一种危及生命的疾病。特别是,脑膜脑炎一直被认为是此类患者最常见的弓形虫并发症。然而,HIV感染患者的弓形虫性脑膜炎极为罕见,在日本,最初应将化脓性或结核性脑膜炎视为需鉴别诊断的疾病。
报告了1例HIV感染患者的弓形虫性脑膜炎。一名36岁的日本男性出现发热、搏动性头痛、腰痛、恶心和呕吐。包括脑脊液检查、影像学检查和血清学检测在内的各项检查均未提示弓形虫病。使用石蜡包埋切片进行聚合酶链反应分析的结果被视为诊断的确凿证据。
我们希望强调,如果石蜡包埋组织切片显示有感染病原体或提示某些传染病的表现,那么从经常规组织病理学检查处理的石蜡包埋组织切片中提取核酸进行聚合酶链反应分析是有用的。