Eggers C, Gross U, Klinker H, Schalke B, Stellbrink H J, Kunze K
Department of Neurology, University Hospital, Hamburg, Germany.
J Neurol. 1995 Oct;242(10):644-9. doi: 10.1007/BF00866914.
The diagnosis of acquired immunodeficiency syndrome-associated toxoplasmic encephalitis (TE), a typically focal disease resulting from reactivation of tissue cysts, relies mainly on indirect diagnostic methods. In a prospective study, we investigated the value of detection of Toxoplasma gondii in cerebrospinal fluid (CSF) by using the polymerase chain reaction and the mouse inoculation test. Twenty-four patients with 26 episodes of TE, 2 HIV-infected patients with primary acute Toxoplasma infection, and 38 HIV-infected control patients with latent Toxoplasma infection were investigated. Detection of T. gondii in CSF by both methods was possible in only 3 of the TE patients (11.5%), the remaining patients being negative with either of the methods. In contrast, T. gondii DNA was detected in both of the acutely infected patients, indicating that in primary acute toxoplasmosis parasites may easily be found in the CSF, whereas in the majority of TE cases in immunocompromised patients, T. gondii parasites do not gain access to the CSF drawn by lumbar puncture.
获得性免疫缺陷综合征相关的弓形虫脑炎（TE）是一种由组织囊肿再激活引起的典型局灶性疾病，其诊断主要依赖间接诊断方法。在一项前瞻性研究中，我们通过聚合酶链反应和小鼠接种试验研究了脑脊液（CSF）中弓形虫检测的价值。我们对24例有26次TE发作的患者、2例原发性急性弓形虫感染的HIV感染患者以及38例潜伏性弓形虫感染的HIV感染对照患者进行了研究。仅3例TE患者（11.5%）通过两种方法均可在CSF中检测到弓形虫，其余患者两种方法检测均为阴性。相比之下，在两名急性感染患者中均检测到了弓形虫DNA，这表明在原发性急性弓形虫病中，寄生虫很容易在CSF中被发现，而在免疫功能低下患者的大多数TE病例中，弓形虫寄生虫无法进入腰椎穿刺采集的CSF中。
