Katzenstein T L, Oster S, Kiss K
Københavns Universitet, Neuropatologisk Institut, H:S Rigshospitalet.
Ugeskr Laeger. 1998 Jul 20;160(30):4430-2.
A case of cerebral toxoplasmosis in a HIV-positive man with unusual clinical manifestations and a normal computed tomographic (CT) scanning is presented. Even though most patients with cerebral toxoplasmosis have focal neurological deficits on physical examination, the patients can also present with more diffuse symptoms. Neither the lack of antitoxoplasma antibodies nor normal findings at CT scanning exclude the diagnosis of toxoplasma encephalitis. The sensitivity is higher with magnetic resonance than with CT scanning. We present a case story that demonstrate how delusive cerebral toxoplasmosis can be in HIV positive patients. It is recommended that the possibility of cerebral toxoplasmosis be considered in every HIV-positive patient with neurological symptoms and empirical therapy be instituted on wide indications.
本文报告了一例HIV阳性男性脑弓形虫病患者,其临床表现不寻常且计算机断层扫描(CT)结果正常。尽管大多数脑弓形虫病患者在体格检查时有局灶性神经功能缺损,但患者也可能表现出更弥漫性的症状。抗弓形虫抗体缺乏以及CT扫描结果正常均不能排除弓形虫脑炎的诊断。磁共振成像的敏感性高于CT扫描。我们讲述了一个病例,展示了脑弓形虫病在HIV阳性患者中可能有多具有迷惑性。建议对每一位有神经症状的HIV阳性患者考虑脑弓形虫病的可能性,并在广泛指征下进行经验性治疗。