Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome

• Published in: Infectious diseases (London, England) Vol. 47; no. 5; pp. 277 - 282
• Main Authors: García-García, Concepción, Castillo-Álvarez, Federico, Azcona-Gutiérrez, José M., Herraiz, María J., Ibarra, Valvanera, Oteo, José A.
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01-05-2015; Taylor & Francis
• Subjects: Acquired Immunodeficiency Syndrome - complications; AIDS; AIDS-Related Opportunistic Infections - complications; AIDS-Related Opportunistic Infections - diagnosis; AIDS-Related Opportunistic Infections - therapy; Antiretroviral Therapy, Highly Active; HIV; HIV Infections - complications; Humans; Male; Middle Aged; myelitis; Myelitis - complications; Myelitis - diagnosis; Myelitis - therapy; Nervous System Diseases - pathology; Spinal Cord - pathology; spinal cord disease; Toxoplasma - isolation & purification; toxoplasmosis; Toxoplasmosis - complications; Toxoplasmosis - diagnosis; Toxoplasmosis - therapy; Toxoplasmosis, Cerebral - complications; Toxoplasmosis, Cerebral - diagnosis; Toxoplasmosis, Cerebral - therapy; spinal cord disease; AIDS; HIV; toxoplasmosis; myelitis
• ISSN: 2374-4235; 2374-4243
• DOI: 10.3109/00365548.2014.993421

Abstract
Neurological complications in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) are still common, even in the era of highly active antiretroviral therapy. Opportunistic infections, immune reconstitution, the virus itself, antiretroviral drugs and neurocognitive disorders have to be considered when establishing the differential diagnosis. Toxoplasmic encephalitis remains the major cause of space-occupying lesions in the brain of patients with HIV/AIDS; however, spinal cord involvement has been reported infrequently. Here, we review spinal cord toxoplasmosis in HIV infection and illustrate the condition with a recent case from our hospital. We suggest that most patients with HIV/AIDS and myelitis with enhanced spine lesions, multiple brain lesions and positive serology for Toxoplasma gondii should receive immediate empirical treatment for toxoplasmosis, and a biopsy should be performed in those cases without clinical improvement or with deterioration.