艾滋病病毒感染者的脑弓形虫病和肺结核潜伏感染

Rijalun Arridho, Raveinal, Dwitya Elvira
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摘要

弓形虫病是一种由刚地弓形虫引起的机会性感染,影响全球三分之一的人口,通常累及中枢神经系统(CNS)/大脑。在一些病例报告中,脑弓形虫病的影像学诊断常有明显征象,但亚临床征象的报告并不多见。我们报告了一例 28 岁男性患者,主诉头痛,入院前 3 天开始加重。他在入院时首次被确认为艾滋病毒感染者。CT 扫描显示左侧额叶区域有轻微的灶周水肿。患者被诊断为脑弓形虫病和潜伏结核感染,处于艾滋病临床Ⅳ期。患者接受了脑弓形虫病的经验性治疗,治疗 7 天后症状缓解。脑弓形虫病通常与艾滋病病毒感染者有关,会导致弓形虫感染再活化。中枢神经系统弓形虫病的临床表现不尽相同,在发现推测性诊断之前,可以发现正常的脑部 CT。
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Cerebral Toxoplasmosis and Latent Tuberculosis Infection in HIV Infected Patient
Toxoplasmosis is an opportunistic infection caused by Toxopasma gondii, which affects one third of the global human population and commonly involves the central nervous system (CNS)/brain. The diagnosis of obvious sign of imaging method cerebral toxoplasmosis is commonly reported in several case report, but subclinical sign of imaging is uncommon reported. We reported a case of 28-years-old male with chief complaint headache that worsening since 3 days before admission. He was first recognized as HIV infected patient on hospital admission. CT scan revealed minimal perifocal oedema in left frontal region. Patient was diagnosed as cerebral toxoplasmosis and latent tuberculosis infection in HIV clinical stadium IV. Patient recieved empirical therapy of cerebral toxoplasmosis and symptom relieved after 7 days of treatment. Cerebral toxoplasmosisis typically associated with HIV infected patient that result in the reactivation of Toxoplasma gondii infection. Clinical presentation of CNS toxoplasmosis varies and normal brain CT can be found despited presumptive diagnosis was revealed.
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