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孤立性小脑弓形虫病作为HIV感染的首发表现：一例报告并文献复习

Solitary Cerebellar Toxoplasmosis as the First Presentation of HIV Infection: A Case Report and Review of Literature.

作者信息

Turkistani Alaa N, AlSindi Tala, Homoud Mohammed, Alghamdi Fahad, Baeesa Saleh S

机构信息

Neurosurgery, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.

Neurosciences, King Faisal Specialist Hospital and Research Centre, Jeddah, SAU.

出版信息

Cureus. 2024 Sep 29;16(9):e70456. doi: 10.7759/cureus.70456. eCollection 2024 Sep.

DOI:10.7759/cureus.70456
PMID:39473656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11521545/
Abstract

Toxoplasmosis is the most common space-occupying lesion in HIV-infected patients that typically presents as a space-occupying lesion in the supratentorial region, often manifesting as focal neurological deficits. Infratentorial toxoplasmosis is extremely rare, with a few reported cases in the literature. Here, we are reporting a 53-year-old healthy female presented with isolated single cerebellar toxoplasmosis as a first manifestation of HIV infection. The patient underwent suboccipital craniotomy and tumor excision, and the subsequent histopathological exam revealed toxoplasma protozoan. While cerebral toxoplasmosis is common in HIV-infected patients, cerebellar involvement is rare and requires prompt diagnosis for effective treatment. A high index of suspicion is emphasized to prompt early diagnosis and initiation of therapy.

摘要

弓形虫病是HIV感染患者中最常见的占位性病变，通常表现为幕上区域的占位性病变，常伴有局灶性神经功能缺损。幕下弓形虫病极为罕见，文献中仅有少数病例报道。在此，我们报告一名53岁健康女性，以孤立的单个小脑弓形虫病作为HIV感染的首发表现。患者接受了枕下开颅手术及肿瘤切除，随后的组织病理学检查发现了弓形虫原虫。虽然脑弓形虫病在HIV感染患者中很常见，但小脑受累罕见，需要及时诊断以进行有效治疗。强调高度怀疑指数以促使早期诊断和开始治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/75b77be16988/cureus-0016-00000070456-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/a78ad81749b8/cureus-0016-00000070456-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/aa1ad447d51c/cureus-0016-00000070456-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/75b77be16988/cureus-0016-00000070456-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/a78ad81749b8/cureus-0016-00000070456-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/aa1ad447d51c/cureus-0016-00000070456-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0653/11521545/75b77be16988/cureus-0016-00000070456-i03.jpg

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本文引用的文献

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Neuro-toxoplasmosis and fatal necrotizing cerebellitis.神经型弓形虫病与致命性坏死性小脑炎
Autops Case Rep. 2022 Mar 2;12:e2021363. doi: 10.4322/acr.2021.363. eCollection 2022.
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Epidemiology, Pathophysiology, Diagnosis, and Management of Cerebral Toxoplasmosis.脑弓形虫病的流行病学、病理生理学、诊断及管理
Clin Microbiol Rev. 2020 Nov 25;34(1). doi: 10.1128/CMR.00115-19. Print 2021 Mar 17.
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HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease.再探与HIV相关的脑弓形虫病：一种古老疾病的当前概念与争议
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958219867315. doi: 10.1177/2325958219867315.
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A systematic review and meta-analysis of the relative efficacy and safety of treatment regimens for HIV-associated cerebral toxoplasmosis: is trimethoprim-sulfamethoxazole a real option?对HIV相关脑弓形虫病治疗方案的相对疗效和安全性的系统评价与荟萃分析：甲氧苄啶-磺胺甲恶唑真的是一种选择吗？
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Human Immunodeficiency Virus-Associated Cerebral Aneurysmal Vasculopathy: A Systematic Review.人类免疫缺陷病毒相关的脑动脉瘤性血管病：一项系统综述
World Neurosurg. 2016 Mar;87:220-9. doi: 10.1016/j.wneu.2015.11.023. Epub 2015 Nov 23.
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Usefulness and limitations of polymerase chain reaction in the etiologic diagnosis of neurotoxoplasmosis in immunocompromised patients.聚合酶链反应在免疫功能低下患者神经型弓形虫病病因诊断中的应用价值及局限性
J Neurol Sci. 2014 Nov 15;346(1-2):231-4. doi: 10.1016/j.jns.2014.08.034. Epub 2014 Aug 30.
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AIDS-related cerebral toxoplasmosis in São Paulo State, Brazil: marked improvements in the highly active antiretroviral therapy-era but the challenges continue.巴西圣保罗州与艾滋病相关的脑弓形虫病：在高效抗逆转录病毒治疗时代有显著改善，但挑战仍在继续。
Braz J Infect Dis. 2013 May-Jun;17(3):379-80. doi: 10.1016/j.bjid.2012.10.030. Epub 2013 Apr 20.
8
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9
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