ABSTRACT
【Objective】 To construct an acute toxoplasma encephalitis mouse model by observing the pathological changes in the hippocampus of mice infected with Toxoplasma gondii strain RH. 【Methods】 The quantitative RH Toxoplasma gondii (100, 500, and 1 000 trophozoites) were injected into the hippocampal CA1 region of mice by the stereotaxic surgery; the survival status of mice was observed. Giemsa staining was used to observe the changes of toxoplasma in mouse ascites and brain tissue homogenates. Nissl staining and HE staining were used to observe the pathological changes of hippocampal nerve tissue. The distribution of Toxoplasma gondii in brain tissue was observed by immunohistochemical ABC method. 【Results】 The RH Toxoplasma gondii infected mice showed obvious symptoms such as arched back, bristling hair, abdominal distension, subtle tremor and hemiplegia on the fourth day of infection. The survival of mice in 100 trophozoites group was longer, no trophozoites of Toxoplasma gondii were found in ascites, a few pseudocysts were found in brain tissue homogenates after infected for 96 hours, and more trophozoites were found after death. Nysl staining and HE staining showed more tissue necrosis foci and loss of nerve cells in CA1 area after infected 144 h. The injury aggravated with the prolongation of infection time. Toxoplasma trophozoites were found in ascites and brain homogenates of mice in 500 and 1000 trophozoites groups. Nissl staining revealed neuronal loss and massive necrosis in the hippocampus. HE staining showed necrosis and inflammatory cell infiltration. The brain tissue injury significantly aggravated compared with 100 trophozoites group. The distribution of Toxoplasma gondii in the necrotic foci was confirmed by immunohistochemistry. 【Conclusion】 The survival of 100 trophozoite mice infected with Toxoplasma gondii strain RH was longer, and the pathological changes of brain tissue gradually aggravated. The damage was relatively confined to the brain tissue, and the mice showed typical symptoms of toxoplasma encephalitis. Therefore, the mouse model of acute toxoplasma encephalitis can be constructed by localized infection of 100 toxoplasma trophozoites, which can lay a foundation for future research on the mechanism of toxoplasma injury to cranial nerves.
ABSTRACT
Objective: To examine the differences in effectiveness and side effects between pyrimethamine-based and non-pyrimethaminebased regimens for toxoplasma encephalitis since the availability of pyrimethamine in Indonesia is currently limited due to its withdrawal from the market. Methods: A systematic review and meta-synthesis study that was carried out by following a protocol guided by the Preffered Reporting Items for Systematic Review and Meta-analysis (PRISMA). Effectiveness measures included clinical improvement, mortality, and radiological improvement. We evaluated selected articles narratively because of the limitations of homogeneity. The risk of bias in RCTs was assessed using the Cochrane Risk of Bias tool for RCT (ROB 2.0) and cohort studies were assessed using the Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-1) tool. Research quality was assessed using the GradePro software. Results: We included two retrospective cohort studies and one RCT. Narrative outcome assessment in these three studies did not show significant difference in effectiveness between pyrimethamine-based and non-pyrimethamine-based regimens for toxoplasma encephalitis treatment. However, drug side effects were consistently higher in the pyrimethamine-based regimen. Conclusions: This study has a high risk of bias. The quality of the research also has a low recommendation value. However, the results may be considered for application if a standard regimen is not available.
ABSTRACT
Toxoplasma encephalitis is an opportunistic infection that may occur in immunocompromised or advanced HIV (Human Immunodeficiency Virus) patients and lead to serious complications in the CNS. We report a 44-year-old man with toxoplasma encephalitis combined with HIV infection. He was admitted with headache and neck stiffness. Brain computed tomography showed normal findings. Tuberculous meningitis was suspected from CSF and serum tests. However, his symptoms continued to progress, and toxoplasma encephalitis was diagnosed based on brain magnetic resonance imaging and serum tests.
Subject(s)
Adult , Humans , Humans , Brain , Encephalitis , Headache , HIV Infections , HIV , Magnetic Resonance Imaging , Neck , Opportunistic Infections , Toxoplasma , Tuberculosis, MeningealABSTRACT
Objective To assess the diagnostic value of CT and MRI findings of toxoplasma encephalitis among AIDS patients.Methods CT and MRI findings of toxoplasma encephalitis were retrospectively studied in 17 AIDS cases.Results The lesions were bilateral and multiple,involving basal nuclei in 12 cases,thalamus in 3 cases,bilateral cerebral hemispheres near corticomedullary junction in 1 case,and cerebellum and brain stem in 1 case.The lesions showed weak hypodensity on CT,and long T 1 and long T2 signal intensity on MRI,with marked peripheral edema effect.After contrast administration,the small ring or twist and target enhancement was seen in 12 cases,large ring enhancement-in 1 case.multiple focus in 15 cases and single focus in 2 cases;MRI was more sensitive in detecting a largest number of cerebral lesions than CT.Conclusion More small ring and twist,nodular,target enhancement are highly suggestive of toxoplasma encephalitis in the basal nuclei.Both CT and MRI are effective in diagnosing toxoplasma encephalitis,but MRI imaging without and with gadolinium is more sensitive than CT in the detection of toxoplasma encephalitis;MRI imaging may reveal a greater number of lesion when it is positive and so the detection rate of MRI is higher than that of CT.
ABSTRACT
Fifty-two AIDS patients with principal diagnosis of Crytococcal meningitis were dead (no autopsy) in the hospital, the ration of male to female was 1.7:1. 52 percent dead on 1st diagnosis and 1st admission duration between symptoms begun and dead average 15.27 days. 21.2 percent dead on 2nd or 3rd admission average time from 1st diagnosis to dead was 113.2 days. 3.8 percent showed clinical of chronic sepsis without eningoencephalitis average time until dead was 28.5 days 1.9 percent was dual fungal septicemia (C.neoformans and P.marneffei). 3.8 percent dual infection Cryptococcus combined with eoxoplasmosis. 9.7 percent dead from bran death but laboratory data to confirm diagnosis of Crytococcal meningitis were conflicted. 3.8 percent dead from hepatic failure (from anti TB drug), this patient develop pulm. And In. during maintenance Rx CM, or renal failure (from amphotericin). 3.8 percent dead from Salmonella gr. B sepsis or other new fungus (Cladophilophora bantiana). Fifteen AIDS patients with principal diagnosis of Toxoplasma encephalitis were dead (no autopsy) in the hospital, the ratio of male to female was 2:1. 46.7 percent dead from brain death average time from symptoms begun to dad was 16.6 days. 33.4 percent dead from severe thrombocytopenia (with massive lower G.I. hemorrhage or massive epistaxis) and / or severe leucopenia (with sepsis), which were side effect of pyrimethamine, average time to develop this side effect was 19 days and average time from symptoms of TE begun to dead was 37 days. 13.3 percent dead from pneumocystis carinii pneumonia or cavernous sinus thrombophlebitis. 6.6 percent dead from HIV encephalopathy with AIDS dementia complex.