Meningoencephalitis due to Toxoplasma gondii and Trypanosoma cruzi in patients with HIV infection. Diferencial diagnosis of pathologic and tomographic findings

Twenty-two HIV+ patients with encephalitis were studied. Of these, 7 had meningoencephalitis due to Toxoplasma gondii (MT) and 15 due to Trypanosoma cruzi (MC). Pathologic and computerized axial tomography (CAT) changes were compared. We found that focal necrotizing encephalitis due to Toxoplasma involved the cerebral cortex and the basal ganglia, whereas lesions due to Trypanosoma cruzi were centered in the white matter, sometimes extending into the cortex. Hemorrhages, myelin lesions and organisms were more pronounced in chagasic than in toxoplasmic encephalitis. These findings are consistent with the literature reviewed. Key-words: AIDS. AIDS x Chagas' disease. AIDS x toxoplasmosis. Meningoencephalitis. Encephalitis. Meningoencephalitis due to Toxoplasma gondii and Trypanosoma cruzi in patients with HIV infection. Diferencial diagnosis of pathologic and tomographic findings Javier E. Lazo, Antonio Carlos Oliveira Meneses, Ademir Rocha, Jack K. Frenkel, Jaime Olavo Marquez, Edmundo Chapadeiro e Edison Reis Lopes Revista da Sociedade Brasileira de Medicina Tropical 31:163-171, mar-abr, 1998. 164 Os dados ate hoje conhecidos2 9 indicam haver semelhanca no comportamento clinico, laboratorial, radiologico e anatomopatologico entre portadores das associacoes virus da imunodeficiencia humana (HIV) com doenca de Chagas (DC) e sindrome da imunodeficiencia adquir ida (AIDS) com toxoplasmose (T), particularmente nas lesoes encefalicas que se desenvolvem em ambas as associacoes. O crescente aumento do numero de casos relatados da associacao HIV-DC, especialmente no Brasil, na Argentina e no Chile, e a alta frequencia mundial da associacao AIDST, levaram-nos a pesquisar dados diferenciais anatomopatologicos e de imagem pela tomografia axial computadorizada do crânio (TAC) entre as encefalopatias chagasica e toxoplasmica, em pacientes HIV+.

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