A case of toxoplasmic encephalitis in a patient on cancer chemotherapy in Uganda.

IF 0.9 African health sciences Pub Date : 2024-12-01 DOI:10.4314/ahs.v24i4.14

Yekosani Mitala, Raymond Atwine, Abraham Birungi, Ambaru Jacinta, Kuraishi Baluku, Semei Sekitene, Edwin Nuwagira

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Abstract

Background: Reactivation of central nervous system (CNS) toxoplasmosis can be caused by immunosuppression (ISS) of any kind. However, anti-cancer chemotherapy combined with human immunodeficiency virus (HIV) induced ISS results in an atypical presentation that is fatal.

Case presentation: A 46 years old man with a well-controlled infection of the human immunodeficiency virus presented with generalized tonic-clonic seizures following the second dose of anti-cancer chemotherapy for esophageal cancer. His brain's computerized tomography (CT) scan showed enlarged ventricles with no space-occupying lesions. Cerebrospinal fluid (CSF) smears stained with hematoxylin and eosin (H&E) revealed numerous bradyzoites and tachyzoites consistent with central nervous system toxoplasmosis.

Conclusion: With a double burden of cancer and Human immunodeficiency virus (HIV) infection in low-income countries, this case raises awareness about the atypical presentation of CNS toxoplasmosis reactivation among patients on cancer chemotherapy.

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乌干达癌症化疗患者弓形虫脑炎病例。

背景：免疫抑制（ISS）可引起中枢神经系统（CNS）弓形虫病的再激活。然而，抗癌化疗联合人类免疫缺陷病毒（HIV）诱导的ISS结果是非典型的，是致命的。病例介绍：一名46岁男性，感染人类免疫缺陷病毒控制良好，在食管癌第二次抗癌化疗后出现全身性强直阵挛发作。脑部电脑断层扫描显示脑室增大，未见占位性病变。苏木精和伊红（H&E）染色的脑脊液（CSF）涂片显示大量慢速虫和速速虫，与中枢神经系统弓形虫病一致。结论：在低收入国家癌症和人类免疫缺陷病毒（HIV）感染的双重负担下，本病例提高了人们对癌症化疗患者中枢神经系统弓形虫病再激活的非典型表现的认识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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African health sciences

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