Please enable JavaScript.
Coggle requires JavaScript to display documents.
HIV Associated Cerebral Toxoplasmosis - Coggle Diagram
HIV Associated Cerebral Toxoplasmosis
HIV definition
The human immunodeficiency virus (HIV) is an enveloped retrovirus that contains 2 copies of a single-stranded RNA genome. It causes the acquired immunodeficiency syndrome (AIDS) that is the last stage of HIV disease
Differential Diagnosis
CNS lymphoma
CNS tuberculosis
Cryptococcus
Neurosyphilis
Cardioembolic stroke
CMV infection
High grade malignant immunoblastic lymphoma
Herpes simplex
Mycobacterium avium complex(MAC)
Toxoplasmosis
Cerebral toxoplasmosis treatment
Antimicrobial therapy directed against T. gondii
and Antiretroviral therapy for immune recovery
Pyrimethamine and sulfadiazine are most commonly employed in treatment.
Initial therapy is followed by secondary prophylaxis or maintenance therapy which is continued until CD4 plus T-lymphocyte counts are over 200 cells/microliters for more than three month
Cerebral toxoplasmosis definition
Cerebral toxoplasmosis is considered the most common opportunistic infection in AIDS. Clinical manifestations include headache, fever, focal deficits, seizures, confusion, ataxia, lethargy, and visual alterations
HIV diagnosed
Fourth-generation assay: Detect specific antibodies and P24 HIV antigens
Rapid test: Use blood or saliva to detect an HIV infection within hours
Polymerase-chain-reaction: Can be a diagnostic or a confirmative test for HIV infection and can provide information about the viral load
Symptoms
Fatigue
Muscle pain
Skin rash
Headache
Sore throat
Swollen lymph nodes
Joint pain
Night sweats
Diarrhea
HIV pathophysiology
HIV attaches to the CD4 molecule and CCR5 (a chemokine co-receptor); the virus' surface fuses with the cellular membrane
allows it entry into a T-helper lymphocyte. After integration in the host genome, the HIV provirus forms and then follows transcription and viral mRNA production.
HIV structural proteins are made and assembled in the host cell. Viral budding from host cells can release millions of HIV particles that can go to infect other cells.
Cerebral toxoplasmosis risk factor
Toxoplasma gondii, an exclusively intracellular, coccidian protozoan parasite with worldwide distribution
Transmission occurs following ingestion of infectious oocysts from contaminated meat, other food, or water.
HIV etiology
The cause of this infectious disease is the human immunodeficiency virus (HIV), which can be classified into HIV-1 and HIV-2. HIV-1 is more globally expanded and virulent. It originated in Central Africa. HIV-2 is much less virulent and comes from West Africa
Cerebral toxoplasmosis diagnosed
Symptoms
Seizures and focal neurologic deficits
Common symptoms include a headache, confusion, and lethargy. Fever may be present but often absent.
Lab
Lactate dehydrogenase (LDH) can be increased markedly in patients with disseminated toxoplasmosis and pulmonary diseas
CD4 count less than 100 cells/microliter without any effective prophylaxis
A positive T. gondii IgG antibody (Anti-toxoplasma IgM antibodies are usually absent except rarely in cases of primary infection. Quantitative IgG antibody titers are not helpful in diagnosis.)
Brain imaging (preferably MRI) that demonstrates a typical radiographic appearance
Cerebral toxoplasmosis pathophysiology
After ingestion of the infective forms, the organism invades the intestinal epithelium and subsequently disseminates throughout the body.
The dormant forms are called bradyzoites while the actively replicating forms are called tachyzoites.
Primary toxoplasmosis is often subclinical but could rarely present symptomatically in an immunocompromised seronegative person who became recently exposed to the infective forms.
In this scenario, IgM to a toxoplasma is often positive, but IgG is not, unlike most reactivation cases, when IgG is the only positive serology test.
Complications
Changes in personality
Seizures
Cranial nerve palsy
Hemiparesis
Hemianopia
Ataxia
Aphasia
HIV Stage
Patients with HIV and CD4 counts greater than 200, but less than 500 do not have AIDS but can develop chronic infections as well as noninfectious conditions.
Patients with a CD4 count less than 200 have AIDS and are susceptible to opportunistic infections. They usually have a lifespan of 2 years if they are started on HAART.
Prognosis
he prognosis of a patient with HIV and a CD4 count greater than 500 (normal) results in a life expectancy as someone without HIV. A person with untreated AIDS has a life expectancy of about 1 to 2 years after the first opportunistic infection
SIklus hidup toksoplasmos
