[The colorful clinical spectrum of cerebral toxoplasmosis in five HIV positive cases: what comes out of Pandora's box?]. / HIV pozitif bes olguda serebral toksoplazmozisin renkli klinigi: Pandora'nin kutusundan çikanlar.

In patients with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), the most common cause of focal intracranial lesion is Toxoplasma gondii infection. T. gondii encephalitis is an easily and effectively treatable disease, with promising outcomes. T. gondii has the potential to form a focal infection niche anywhere in the central nervous system, thus allowing for a colorful clinical picture. In this report, we attempted to present five HIV/AIDS cases with central nervous system toxoplasmosis demonstrating five different neurological presentations. The ages, gender and clinical findings of the patients who were admitted to our Infectious Diseases Clinics were as follows; 35 years old male patient with delirium, 49 years old male patient with focal dystony, 32 years old female patient with facial paralysis and monoparalysis, 53 years old male patient with Wernicke syndrome, 32 years old male patient with epilepsy. Cerebral toxoplasmosis were diagnosed by clinical findings and imaging techniques. The patients were treated with trimetoprim-sulfametoxazol (TMP-SMZ) and haloperidol, only TMP-SMZ, clindamycin and daraprim, TMP-SMZ and levotiracetam, TMP-SMZ and phenytoin, respectively, with recovery in neurological and radiological symptoms. In conclusion, until proven otherwise, HIV/AIDS patients presenting with focal neurological complaints should be accepted as having central nervous system toxoplasmosis.

Pleomorphism of the clinical manifestations of neurocysticercosis.

Neurocysticercosis (NCC) remains a major public health problem in developing countries as it is the most common helminthic infection of the central nervous system. Clinical manifestations are non-specific and pleomorphic. Case reports on uncommon presentations of NCC are few. We report six interesting cases of NCC with unusual clinical presentation that demonstrate this spectrum of pleomorphism. These include extrapyramidal disease (parkinsonism and focal dystonia), Kluver-Bucy syndrome, Weber's syndrome, dementia and cortical blindness. The clinical details and possible mechanisms for the uncommon presentations are also discussed. Thus, a high level of suspicion should be kept for NCC, especially in endemic zones and developing countries.