Cerebral Toxoplasmosis in an HIV Patient with Fatal Outcome

Abstract

Background: Latent toxoplasmosis is present in a third of the world population, however, 80% of cases are asymptomatic. In HIV patients, encephalitis caused by Toxoplasma is the most common opportunistic infection and cause of focal brain lesions with a fatal outcome. In these patients, a clinical deterioration occurs despite increased CD4 counts and decreased plasma HIV viral load; this phenomenon has been described as Immune Restoration Disease (IRD) or the Immune Reconstitution Inflammatory Syndrome (IRIS). During this syndrome it is possible the reactivation of opportunistic infections as Toxoplasma, because the immune system has an abnormal inflammatory reaction.

Aims: The aims in this case was to diagnose the existence of cerebral toxoplasmosis in a pediatric patient with HIV.

Methods: Mycobacterium tuberculosis culture and polymerase chain reaction. To Diagnostic of Brain Toxoplasmosis; Computerized Tomography of brain Enzyme Liked Absorbent assay (ELISA) IgG e IgM, PCR and Western-Blot were performed.

Results: Anti-Toxoplasma antibodies IgM negative and IgG test was positive >300 IU/mL, Western-blot was positive to IgG antibodies. Toxoplasma DNA was negative through Polymerase Change Reaction.

Conclusion: High level of IgG antibodies confirmed by Western blot, and the image studies of Computerized Tomography of brain confirmed a Neurotoxoplasmosis.