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conferenceseries
.com
Volume 3
October 03-04, 2018 Osaka, Japan
Pediatric Neurology & Medicine
3
rd
International conference on
N
euroscience
, N
euroradiology
and
I
maging
Neuroimaging 2018
October 03-04, 2018
J Pediatr Neurol Med 2018, Volume 3
DOI: 10.4172/2472-100X-C1-003
Multiple intracranial opportunistic infections in patient with Acquired Immunodeficiency
Syndrome (AIDS): Case report and literature review
Yanli Zhang, Tianhong Wang and Junqiang Lei
The First Hospital of Lan Zhou University, China
Background:
Intracranial opportunistic infections which can occur alone or in combination with several others in individuals
with HIV infection. As for the diagnosis, the value of laboratory examinations and biopsies is likely limited because of low
sensitivity and the risk of complications. Neuroimaging, especially MRI, has evolved as an effective supplementary method for
diagnosis.
Case Report:
A 30-year-old male patient was admitted to the Department of Gastroenterology with abdominal pain, diarrhea
and palpable mass on the neck. During the workup, he was conclusively diagnosed with AIDS and lymphatic tuberculosis and
he received treatment of Highly Active Antiretroviral Therapy (HAART) and anti-tuberculosis therapy. Eight weeks later, as the
result of drug withdrawal, he was readmitted to the hospital and diagnosed Tuberculous Meningocephalitis Q2 (TBMC) based
on the cranial Magnetic Resonance Imaging (MRI) and Cerebrospinal Fluid (CSF) examination. Anti-tuberculosis therapy
was restarted again. After 5 months, there was improvement of the original lesion on imaging. However, with the weakness of
right side of the body, a new infarction (in the distribution of left middle cerebral artery) appeared on the Diffusion Weighted
Imaging (DWI). Meanwhile,
T. gondii
immunoglobulin (Ig) G antibodies were positive and two new ring-like enhancingmasses
with eccentric target signs appeared in the left parietal lobe and cerebellum, which supported the diagnosis of Toxoplasmosis
Encephalopathy (TE). Therefore, treatment of toxoplasmosis was initiated immediately. Here, we report a case of multiple
intracranial opportunistic infections including TBMC and TE in an AIDS patient.
Conclusion:
This case alerted us to pay close attention to the multiple intracranial opportunistic infections in individual with
AIDS such as bacterial, fungal, viral and parasitic infections. MR findings, combined with clinical presentation, serum and
CSFIgG examination, could be helpful to the differential diagnosis.
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