隐匿于明显之处：中枢神经系统弓形虫病治疗后进行性多灶性白质脑病的出现。
Hidden in plain view: emergence of progressive multifocal leukoencephalopathy after treatment of CNS toxoplasmosis.
机构信息
Division of NeuroVirology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
出版信息
Acta Neurol Belg. 2011 Sep;111(3):217-9.
Multiple CNS infections can coexist in advanced AIDS, but are most commonly reported in autopsy case studies. We describe the case of an HIV+ individual, who was first diagnosed with CNS toxoplasmosis, confirmed by brain biopsy. After initiation of combined anti-retroviral therapy (cART) and successful treatment of CNS toxoplasmosis, he developed worsening neurological symptoms and was subsequently diagnosed with progressive multifocal leukoencephalopathy. Retrospective analysis of the MRI scans indicated that PML was already present early on but was interpreted as edema associated with CNS toxoplasmosis. Clinicians should be aware that multiple pathologies may coexist in the brain of immunosuppressed individuals and that PML may develop and worsen despite the use of cART.
多种中枢神经系统感染可同时存在于晚期艾滋病患者中，但在尸检病例研究中最为常见。我们描述了一例 HIV 阳性个体的病例，该个体最初被诊断为中枢神经系统弓形体病，通过脑部活检得到证实。在开始联合抗逆转录病毒治疗（cART）并成功治疗中枢神经系统弓形体病后，他出现了恶化的神经症状，随后被诊断为进行性多灶性白质脑病。对 MRI 扫描的回顾性分析表明，PML 很早就已经存在，但被解释为与中枢神经系统弓形体病相关的水肿。临床医生应该意识到，免疫抑制个体的大脑中可能存在多种病变，并且尽管使用 cART，PML 仍可能发展和恶化。
Zotero 插件