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Case No. 453
2017-08-01~2017-08-31
출제자 : 강경미
Hit : 309
| Period | 2017-08-01~2017-08-31 |
|---|---|
| Diagnosis | Toxoplasmosis (HIV viral load : 137,389 copies/mL (+)) |
| Clinical information | M/53 Rt. extremity weakness (1WA) 진단은? |
| Discussion | Toxoplasmosis (HIV viral load : 137,389 copies/mL (+)) Opportunistic parasitic infection caused by Toxoplasma gondii Most common opportunistic CNS infection in patients with AIDS Toxoplasma in AIDS – necrotizing encephalitis of 3 layers 1) Central avascular zone reflecting coagulative necrosis 2) Intermediate zone engorged with blood vessels containing tachyzoites (corresponds to enhancing ring) 3) Peripheral zone with more encysted bradyzoites (corresponds to edema on imaging) Imaging findings – CE-CT : Solid, nodular-enhancing, or ring-enhancing lesions – TI-WI : central iso to low SI, ring-enhancing on enhancement • Target sign highly suggestive of TE • Enhancing nodule within enhancing rim – Perfusion MR : Reduced rCBV Differential Diagnosis Lymphoma • Solitary mass in patient with HIV/AIDS? ○ Lymphoma > toxoplasmosis Other Opportunistic Infections • Cryptococcosis, PML (usually does not enhance) |
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