TY - JOUR
T1 - Clinical presentation and diagnosis of toxoplasmic encephalitis in Japan
AU - Sakamoto, Naoya
AU - Maeda, Takuya
AU - Mikita, Kei
AU - Kato, Yasuyuki
AU - Yanagisawa, Naoki
AU - Suganuma, Akihiko
AU - Imamura, Akifumi
AU - Nakamura-Uchiyama, Fukumi
AU - Miyahira, Yasushi
AU - Kawana, Akihiko
AU - Ohnishi, Kenji
AU - Ajisawa, Atsushi
N1 - Funding Information:
This study was supported in part by a research grant from the Ministry of Health, Labour and Welfare, Japan (H22-Seisakusouyaku-Ippan-003).
PY - 2014/10
Y1 - 2014/10
N2 - Distinguishing life-threatening toxoplasmic encephalitis (TE) from brain lymphoma in patients with acquired immunodeficiency syndrome (AIDS) may be difficult. Empiric anti-toxoplasmosis treatment is often initiated because of the reluctance in performing brain biopsies, which may delay the diagnosis and treatment of brain lymphoma in Japan. In this study, we retrospectively examined the clinical characteristics of 13 AIDS patients with TE in Japan, including magnetic resonance imaging and thallium 201 (201TI) single photon emission computed tomography (SPECT) findings, cerebral spinal fluid analysis, serology, and polymerase chain reaction (PCR) results. All patients improved on anti-toxoplasmosis treatment. Of the 11 patients who underwent serological testing, 6 (55%) had a positive serological result. Of the 7 patients who underwent PCR testing, 3 (42.9%) had a positive PCR result. Nine of 11 patients with TE (81.8%) had multiple lesions. Analysis of the sites of TE lesions did not reveal a difference in site predilection between TE and brain lymphoma. Uptake was negative in all 9 patients who underwent 201Tl SPECT. The study findings suggest that toxoplasma serostatus and PCR may be used to discriminate TE from brain lymphoma. No focal accumulation of 201TI is strongly suggestive of TE in patients with AIDS in Japan.
AB - Distinguishing life-threatening toxoplasmic encephalitis (TE) from brain lymphoma in patients with acquired immunodeficiency syndrome (AIDS) may be difficult. Empiric anti-toxoplasmosis treatment is often initiated because of the reluctance in performing brain biopsies, which may delay the diagnosis and treatment of brain lymphoma in Japan. In this study, we retrospectively examined the clinical characteristics of 13 AIDS patients with TE in Japan, including magnetic resonance imaging and thallium 201 (201TI) single photon emission computed tomography (SPECT) findings, cerebral spinal fluid analysis, serology, and polymerase chain reaction (PCR) results. All patients improved on anti-toxoplasmosis treatment. Of the 11 patients who underwent serological testing, 6 (55%) had a positive serological result. Of the 7 patients who underwent PCR testing, 3 (42.9%) had a positive PCR result. Nine of 11 patients with TE (81.8%) had multiple lesions. Analysis of the sites of TE lesions did not reveal a difference in site predilection between TE and brain lymphoma. Uptake was negative in all 9 patients who underwent 201Tl SPECT. The study findings suggest that toxoplasma serostatus and PCR may be used to discriminate TE from brain lymphoma. No focal accumulation of 201TI is strongly suggestive of TE in patients with AIDS in Japan.
KW - AIDS
KW - PCR
KW - SPECT
KW - Toxoplasmic encephalitis
KW - Toxoplasmosis
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U2 - 10.1016/j.parint.2014.05.007
DO - 10.1016/j.parint.2014.05.007
M3 - Article
C2 - 24929035
AN - SCOPUS:84903618569
SN - 1383-5769
VL - 63
SP - 701
EP - 704
JO - Parasitology International
JF - Parasitology International
IS - 5
ER -
