CHOROID-PLEXUS INFECTION IN CEREBRAL TOXOPLASMOSIS IN AIDS PATIENTS

Citation
Mf. Falangola et Ck. Petito, CHOROID-PLEXUS INFECTION IN CEREBRAL TOXOPLASMOSIS IN AIDS PATIENTS, Neurology, 43(10), 1993, pp. 2035-2040
Citations number
36
Categorie Soggetti
Clinical Neurology
Journal title
ISSN journal
00283878
Volume
43
Issue
10
Year of publication
1993
Pages
2035 - 2040
Database
ISI
SICI code
0028-3878(1993)43:10<2035:CIICTI>2.0.ZU;2-2
Abstract
We evaluated the postmortem incidence of choroid plexus infection in c erebral toxoplasmosis in 17 patients with acquired immune deficiency s yndrome (AIDS) and cerebral toxoplasmosis and, by immunohistochemistry , identified Toxoplasma gondii tachyzoites in this structure in 53% of all cases. They were present in 78% of the nine cases with the acute necrotizing stages of CNS toxoplasmosis but were less frequent (20%) i n patients with only the healed cystic lesions of toxoplasmosis. Large necrotizing abscesses of the choroid plexus were found in three of th e patients. In one of these, the choroid plexus was the sole site of C NS infection, which presented as radiographically documented masses in the third and fourth ventricles associated with obstructive hydroceph alus. These results demonstrate that infection of the choroid plexus i s common with cerebral toxoplasmosis and suggest that this infection s hould be included in the differential diagnosis of intra- or periventr icular lesions in patients with AIDS. In addition, the high frequency of choroid plexus infection with acute cerebral toxoplasmosis suggests that cerebral toxoplasmosis in the immunosuppressed patient may be du e to hematogenous spread to the choroid plexus from reactivation of la tent organisms from systemic organs rather than to reactivation of lat ent organisms within the brain itself. Furthermore, the high frequency of choroid plexitis offers the potential for CSF dissemination of thi s infection.