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Case No. 497
2018-11-01~2018-11-30
출제자 : 김슬기
Hit : 361
| Period | 2018-11-01~2018-11-30 |
|---|---|
| Diagnosis | Toxoplasmosis |
| Gender |
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| Age | 33 |
| Clinical information | 33/M C/C Headache, seizure like movement of right arm (4 hours ago) 진단은? |
| Discussion | Most common opportunistic CNS infection, mass lesion in patients with AIDS Location: Basal ganglia, corticomedullary junction, thalamus, cerebellum Etiology Usually reactivation of latent infection (20-70% of USA population seropositive for T.gondii) Definite host =cat Epidemiology 3-10% of AIDS patiens in USA, 35-50% in Europe and Africa. More common when CD4(+) counts < 200 cells/uL Prognosis In poor socioeconomic environments, median survival is 28 months MR Findings T1WI: Ill defined hypointense lesions. Occasionally hyperintense lesion due to coagulative necrosis T2WI : Hypointense + hyperintense peripheral edema (concentric target sign) DWI: Increased diffusivity in necrotic centers ischemia present T1WI C+: Rim, nodular, punctate enhancement Target sign (enhancing nodule within enhancing rim) highly suggestive of toxoplasmosis PWI: Reduced rCBV |
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