Calcified cerebral toxoplasmosis associated with recurrent perilesional edema causing neurological manifestations in an HIV-infected individual: case report with a decade-long follow-up

Authors

  • Flávia Carolina Soares Bonato Instituto de Infectologia Emílio Ribas, Departamento de Doenças Infecciosas, São Paulo, São Paulo, Brazil https://orcid.org/0009-0006-6905-1887
  • René Leandro Magalhães Rivero Instituto de Infectologia Emílio Ribas, Divisão de Apoio ao Diagnóstico e Terapêutica, Setor de Radiologia, São Paulo, São Paulo, Brazil https://orcid.org/0000-0002-8451-1101
  • Hector Hugo Garcia Universidad Peruana Cayetano Heredia, Centro de Salud Global, Lima, Peru; Instituto de Ciencias Neurológicas, Unidad de Cisticercosis, Lima, Peru https://orcid.org/0000-0002-4633-6269
  • José Ernesto Vidal Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Moléstias Infecciosas, São Paulo, São Paulo, Brazil; Universidade de São Paulo, Faculdade de Medicina, Instituto de Medicina Tropical de São Paulo (LIM-49), São Paulo, São Paulo, Brazil https://orcid.org/0000-0001-7830-8716

DOI:

https://doi.org/10.1590/

Keywords:

Cerebral toxoplasmosis, Pathologic calcification, Edema, Neuroimaging, HIV

Abstract

Four cases of people living with HIV/AIDS (PLWHA) with calcified cerebral toxoplasmosis associated with perilesional edema causing a single episode of neurological manifestations have recently been reported. Here, we describe the first detailed description of perilesional edema associated with calcified cerebral toxoplasmosis causing three episodes of neurological manifestations in a PLWHA, including seizures in two of them. These recurrences occurred over approximately a decade. Throughout this period, the patient showed immunological and virological control of the HIV infection, while using antiretroviral therapy regularly. This case broadens the spectrum of an emerging presentation of calcified cerebral toxoplasmosis, mimicking a well-described finding of neurocysticercosis in immunocompetent hosts.

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Published

2024-03-19

Issue

Section

Case Report

How to Cite

Bonato, F. C. S., Rivero, R. L. M., Garcia, H. H., & Vidal, J. E. (2024). Calcified cerebral toxoplasmosis associated with recurrent perilesional edema causing neurological manifestations in an HIV-infected individual: case report with a decade-long follow-up. Revista Do Instituto De Medicina Tropical De São Paulo, 66, e15. https://doi.org/10.1590/