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José E. Vidal - One of the best experts on this subject based on the ideXlab platform.
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first case report of eosinophilic meningitis associated with Cerebral Toxoplasmosis in an hiv positive patient
International Journal of Std & Aids, 2020Co-Authors: José E. Vidal, Mirella Alves Cunha, Maria Jose Oliveira Kassab, Rafi F Dauar, Dewton De Moraes VasconcelosAbstract:Cerebral Toxoplasmosis is the most common cause of focal brain lesion in people living with HIV (PLWH) and usually causes multifocal encephalitis with little or no meningeal involvement. Classicall...
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HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease.
Journal of the International Association of Providers of AIDS Care, 2019Co-Authors: José E. VidalAbstract:Cerebral Toxoplasmosis is the most common cause of expansive brain lesions in people living with HIV/AIDS (PLWHA) and continues to cause high morbidity and mortality. The most frequent characterist...
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hiv related Cerebral Toxoplasmosis revisited current concepts and controversies of an old disease
Journal of the International Association of Providers of AIDS Care, 2019Co-Authors: José E. VidalAbstract:Cerebral Toxoplasmosis is the most common cause of expansive brain lesions in people living with HIV/AIDS (PLWHA) and continues to cause high morbidity and mortality. The most frequent characteristics are focal subacute neurological deficits and ring-enhancing brain lesions in the basal ganglia, but the spectrum of clinical and neuroradiological manifestations is broad. Early initiation of antitoxoplasma therapy is an important feature of the diagnostic approach of expansive brain lesions in PLWHA. Pyrimethamine-based regimens and trimethoprim-sulfamethoxazole (TMP-SMX) seem to present similar efficacy, but TMP-SMX shows potential practical advantages. The immune reconstitution inflammatory syndrome is uncommon in Cerebral Toxoplasmosis, and we now have more effective, safe, and friendly combined antiretroviral therapy (cART) options. As a consequence of these 2 variables, the initiation of cART can be performed within 2 weeks after initiation of antitoxoplasma therapy. Herein, we will review historical and current concepts of epidemiology, diagnosis, and treatment of HIV-related Cerebral Toxoplasmosis.
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Toxoplasma gondii infection and Cerebral Toxoplasmosis in HIV-infected patients.
Future microbiology, 2009Co-Authors: Vera Lucia Pereira-chioccola, José E. VidalAbstract:Cerebral Toxoplasmosis is a major cause of morbidity and mortality among HIV-infected patients, particularly from developing countries. This article summarizes current literature on Cerebral Toxoplasmosis. It focuses on: Toxoplasma gondii genetic diversity and its possible relationship with disease presentation; host responses to the parasite antigens; host immunosupression in HIV and Cerebral Toxoplasmosis as well as different diagnostic methods; clinical and radiological features; treatment; and the direction that studies on Cerebral Toxoplasmosis will likely take in the future.
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Use of the serum reactivity against Toxoplasma gondii excreted-secreted antigens in Cerebral Toxoplasmosis diagnosis in human immunodeficiency virus-infected patients
Journal of Medical Microbiology, 2008Co-Authors: Cristina Da Silva Meira, José E. Vidal, Thais A. Costa-silva, Isabelle M.r. Ferreira, Roberto Mitsuyoshi Hiramoto, Vera Lucia Pereira-chioccolaAbstract:Despite the development of serological and molecular methods in recent years, the diagnosis of Cerebral Toxoplasmosis in human immunodeficiency virus (HIV)-infected patients still presents difficulties. In the present study, we investigated whether Cerebral Toxoplasmosis induced changes in the reactivity of serum toward Toxoplasma gondii excreted-secreted antigens (ESA) in order to develop an assay for evaluating HIV-infected patients with Cerebral Toxoplasmosis. The antigen selection was based on those produced by tachyzoites, since it is the form of the organism responsible for disseminating the infection, as well as stimulation of the humoral and cellular immune responses. By using an ELISA containing pooled ESA recovered from infected culture supernatants with tachyzoites-RH strain (ESA-ELISA), we found that ESA had a high specificity for sera from patients with Cerebral Toxoplasmosis. The reactions were compared with an ELISA using crude tachyzoites antigen, widely used in traditional serology. The assays were performed on 293 serum samples separated as follows: 100 sera from patients with Cerebral Toxoplasmosis and AIDS (symptomatic), 99 sera from individuals with chronic Toxoplasmosis (asymptomatic) and 94 sera from healthy individuals without Toxoplasmosis (control). The crude tachyzoite antigen in ELISA was able to distinguish both groups of sera with Toxoplasmosis, as similar reactivity were observed in sera from patients with Cerebral Toxoplasmosis and those from chronic individuals. In contrast, ESA-ELISA distinguished sera from symptomatic and asymptomatic individuals (three times more reactive in the former group, 12.6 versus 4.2). The assays were reproducible based on immunoblotting and statistical analysis. These data suggest the utility of ESA-ELISA in the diagnosis of Cerebral Toxoplasmosis in HIV-infected patients, since it provided clear evidence that anti-ESA antibodies are present principally in patients with active infection. The absence of a significant amount of antibodies distinguished the patients without clinical symptoms of infection.
Vera Lucia Pereira-chioccola - One of the best experts on this subject based on the ideXlab platform.
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Toxoplasma gondii infection and Cerebral Toxoplasmosis in HIV-infected patients.
Future microbiology, 2009Co-Authors: Vera Lucia Pereira-chioccola, José E. VidalAbstract:Cerebral Toxoplasmosis is a major cause of morbidity and mortality among HIV-infected patients, particularly from developing countries. This article summarizes current literature on Cerebral Toxoplasmosis. It focuses on: Toxoplasma gondii genetic diversity and its possible relationship with disease presentation; host responses to the parasite antigens; host immunosupression in HIV and Cerebral Toxoplasmosis as well as different diagnostic methods; clinical and radiological features; treatment; and the direction that studies on Cerebral Toxoplasmosis will likely take in the future.
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Use of the serum reactivity against Toxoplasma gondii excreted-secreted antigens in Cerebral Toxoplasmosis diagnosis in human immunodeficiency virus-infected patients
Journal of Medical Microbiology, 2008Co-Authors: Cristina Da Silva Meira, José E. Vidal, Thais A. Costa-silva, Isabelle M.r. Ferreira, Roberto Mitsuyoshi Hiramoto, Vera Lucia Pereira-chioccolaAbstract:Despite the development of serological and molecular methods in recent years, the diagnosis of Cerebral Toxoplasmosis in human immunodeficiency virus (HIV)-infected patients still presents difficulties. In the present study, we investigated whether Cerebral Toxoplasmosis induced changes in the reactivity of serum toward Toxoplasma gondii excreted-secreted antigens (ESA) in order to develop an assay for evaluating HIV-infected patients with Cerebral Toxoplasmosis. The antigen selection was based on those produced by tachyzoites, since it is the form of the organism responsible for disseminating the infection, as well as stimulation of the humoral and cellular immune responses. By using an ELISA containing pooled ESA recovered from infected culture supernatants with tachyzoites-RH strain (ESA-ELISA), we found that ESA had a high specificity for sera from patients with Cerebral Toxoplasmosis. The reactions were compared with an ELISA using crude tachyzoites antigen, widely used in traditional serology. The assays were performed on 293 serum samples separated as follows: 100 sera from patients with Cerebral Toxoplasmosis and AIDS (symptomatic), 99 sera from individuals with chronic Toxoplasmosis (asymptomatic) and 94 sera from healthy individuals without Toxoplasmosis (control). The crude tachyzoite antigen in ELISA was able to distinguish both groups of sera with Toxoplasmosis, as similar reactivity were observed in sera from patients with Cerebral Toxoplasmosis and those from chronic individuals. In contrast, ESA-ELISA distinguished sera from symptomatic and asymptomatic individuals (three times more reactive in the former group, 12.6 versus 4.2). The assays were reproducible based on immunoblotting and statistical analysis. These data suggest the utility of ESA-ELISA in the diagnosis of Cerebral Toxoplasmosis in HIV-infected patients, since it provided clear evidence that anti-ESA antibodies are present principally in patients with active infection. The absence of a significant amount of antibodies distinguished the patients without clinical symptoms of infection.
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Diagnosis of Cerebral Toxoplasmosis in AIDS Patients in Brazil: Importance of Molecular and Immunological Methods Using Peripheral Blood Samples
Journal of clinical microbiology, 2005Co-Authors: Fabio A Colombo, José E. Vidal, Augusto Cesar Penalva De Oliveira, Roberto Focaccia, Adrian V. Hernandez, Francisco Bonasser-filho, Roberta Schiavon Nogueira, Vera Lucia Pereira-chioccolaAbstract:Cerebral Toxoplasmosis is the most common Cerebral focal lesion in AIDS and still accounts for high morbidity and mortality in Brazil. Its occurrence is more frequent in patients with low CD4(+) T-cell counts. It is directly related to the prevalence of anti-Toxoplasma gondii antibodies in the population. Therefore, it is important to evaluate sensitive, less invasive, and rapid diagnostic tests. We evaluated the value of PCR using peripheral blood samples on the diagnosis of Cerebral Toxoplasmosis and whether its association with immunological assays can contribute to a timely diagnosis. We prospectively analyzed blood samples from 192 AIDS patients divided into two groups. The first group was composed of samples from 64 patients with Cerebral Toxoplasmosis diagnosed by clinical and radiological features. The second group was composed of samples from 128 patients with other opportunistic diseases. Blood collection from patients with Cerebral Toxoplasmosis was done before or on the third day of anti-toxoplasma therapy. PCR for T. gondii, indirect immunofluorescence, enzyme-linked immunosorbent assay, and an avidity test for Toxoplasmosis were performed on all samples. The PCR sensitivity and specificity for diagnosis of Cerebral Toxoplasmosis in blood were 80% and 98%, respectively. Patients with Cerebral Toxoplasmosis (89%) presented higher titers of anti-T. gondii IgG antibodies than patients with other diseases (57%) (P
Zsila Sadighi - One of the best experts on this subject based on the ideXlab platform.
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Unusual magnetic resonance imaging presentation of post-BMT Cerebral Toxoplasmosis masquerading as meningoencephalitis and ventriculitis
Bone marrow transplantation, 2016Co-Authors: Kathleen J. Helton, Gabriela Maron, Ewelina Mamcarz, Vasiliki Leventaki, Zoltan Patay, Zsila SadighiAbstract:Unusual magnetic resonance imaging presentation of post-BMT Cerebral Toxoplasmosis masquerading as meningoencephalitis and ventriculitis
John F. Dipersio - One of the best experts on this subject based on the ideXlab platform.
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Successful treatment of Cerebral Toxoplasmosis in a marrow transplant recipient: contribution of a PCR test in diagnosis and early detection.
Bone marrow transplantation, 1999Co-Authors: H Khoury, Douglas Adkins, Randy A. Brown, Lawrence T. Goodnough, Murat Gokden, T Roberts, Gregory A. Storch, John F. DipersioAbstract:We report successful treatment of Cerebral Toxoplasmosis in an unrelated donor marrow transplant recipient. The clinical diagnosis was confirmed by polymerase chain reaction (PCR) amplification for T. gondii-DNA performed both on cerebrospinal fluid and blood leukocytes. Retrospective testing of stored blood samples demonstrated positive leukocyte PCR signal detected up to 52 days prior to onset of clinical symptoms. This case highlights the value of PCR in the diagnosis and early detection of Cerebral Toxoplasmosis.
B. Rotoli - One of the best experts on this subject based on the ideXlab platform.
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Post-transplant Cerebral Toxoplasmosis diagnosed by magnetic resonance imaging
Haematologica, 1998Co-Authors: Marco Picardi, G. De Rosa, F Di Salle, L Pezzullo, Anna Maria Raiola, B. RotoliAbstract:Cerebral Toxoplasmosis is a rare late complication in allogeneic bone marrow transplanted patients. Neuroradiological findings may suggest the correct diagnosis. We report a patient in whom Cerebral magnetic resonance imaging (MRI) showed a lesion characteristic of Toxoplasmosis. Anti-toxoplasma treatment led to clinical and radiological improvement. MRI seems to be a valid tool for detection and follow-up of Cerebral Toxoplasmosis.