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Asymptomatic diffuse "encephalitic" cerebral toxoplasmosis in a patient with chronic lymphocytic leukemia: case report and review of the literature.

Abstract

Opportunistic infections account for the majority of central nervous system lesions in adult immunosuppressed patients. In this setting, toxoplasmosis typically manifests as multiple abscesses readily seen on routine neuroimaging studies. Asymptomatic, widely disseminated Toxoplasma cysts without parenchymal reaction are also recognized. In contrast, widespread parasites in the brain parenchyma with an inflammatory "encephalitic" reaction and little or no necrosis have been reported in only four patients with acquired immune deficiency syndrome (AIDS). We describe a 70 year old male with stage IV chronic lymphocytic leukemia complicated by aplastic anemia. Neurological examination and imaging revealed no significant abnormalities. At autopsy, the brain revealed multifocal cysts and free tachyzoites of Toxoplasma gondii with diffuse microglial nodules and no necrosis. To the best of our knowledge, this case represents the first report of the "encephalitic" form of toxoplasmosis in a non-AIDS patient.

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  • Authors+Show Affiliations

    ,

    Department of Pathology, Georgetown University Hospital, Washington, DC 20007, USA. mxa212@gunet.georgetown.edu

    , , ,

    Source

    MeSH

    Aged
    Anemia, Aplastic
    Brain
    Humans
    Immunocompromised Host
    Leukemia, Lymphocytic, Chronic, B-Cell
    Male
    Opportunistic Infections
    Toxoplasma
    Toxoplasmosis, Cerebral

    Pub Type(s)

    Case Reports
    Journal Article

    Language

    eng

    PubMed ID

    19918334

    Citation

    Abedalthagafi, Malak, et al. "Asymptomatic Diffuse "encephalitic" Cerebral Toxoplasmosis in a Patient With Chronic Lymphocytic Leukemia: Case Report and Review of the Literature." International Journal of Clinical and Experimental Pathology, vol. 3, no. 1, 2009, pp. 106-9.
    Abedalthagafi M, Rushing EJ, Garvin D, et al. Asymptomatic diffuse "encephalitic" cerebral toxoplasmosis in a patient with chronic lymphocytic leukemia: case report and review of the literature. Int J Clin Exp Pathol. 2009;3(1):106-9.
    Abedalthagafi, M., Rushing, E. J., Garvin, D., Cheson, B., & Ozdemirli, M. (2009). Asymptomatic diffuse "encephalitic" cerebral toxoplasmosis in a patient with chronic lymphocytic leukemia: case report and review of the literature. International Journal of Clinical and Experimental Pathology, 3(1), pp. 106-9.
    Abedalthagafi M, et al. Asymptomatic Diffuse "encephalitic" Cerebral Toxoplasmosis in a Patient With Chronic Lymphocytic Leukemia: Case Report and Review of the Literature. Int J Clin Exp Pathol. 2009 Mar 15;3(1):106-9. PubMed PMID: 19918334.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Asymptomatic diffuse "encephalitic" cerebral toxoplasmosis in a patient with chronic lymphocytic leukemia: case report and review of the literature. AU - Abedalthagafi,Malak, AU - Rushing,Elisabeth J, AU - Garvin,David, AU - Cheson,Bruce, AU - Ozdemirli,Metin, Y1 - 2009/03/15/ PY - 2009/02/08/received PY - 2009/03/04/accepted PY - 2009/11/18/entrez PY - 2009/11/18/pubmed PY - 2010/3/3/medline KW - Toxoplasma KW - Toxoplasmosis KW - central nervous system KW - chronic lymphocytic leukemia SP - 106 EP - 9 JF - International journal of clinical and experimental pathology JO - Int J Clin Exp Pathol VL - 3 IS - 1 N2 - Opportunistic infections account for the majority of central nervous system lesions in adult immunosuppressed patients. In this setting, toxoplasmosis typically manifests as multiple abscesses readily seen on routine neuroimaging studies. Asymptomatic, widely disseminated Toxoplasma cysts without parenchymal reaction are also recognized. In contrast, widespread parasites in the brain parenchyma with an inflammatory "encephalitic" reaction and little or no necrosis have been reported in only four patients with acquired immune deficiency syndrome (AIDS). We describe a 70 year old male with stage IV chronic lymphocytic leukemia complicated by aplastic anemia. Neurological examination and imaging revealed no significant abnormalities. At autopsy, the brain revealed multifocal cysts and free tachyzoites of Toxoplasma gondii with diffuse microglial nodules and no necrosis. To the best of our knowledge, this case represents the first report of the "encephalitic" form of toxoplasmosis in a non-AIDS patient. SN - 1936-2625 UR - https://www.unboundmedicine.com/medline/citation/19918334/Asymptomatic_diffuse_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19918334/ DB - PRIME DP - Unbound Medicine ER -