Neuroimaging of HIV-associated cryptococcal meningitis: comparison of magnetic resonance imaging findings in patients with and without immune reconstitution.
To determine the frequency, imaging characteristics, neuroanatomical distribution and dynamics of magnetic resonance imaging findings in HIV-associated cryptococcal meningitis in immunocompromised patients we compared patients without antiretroviral therapy with patients undergoing immune reconstitu...
| Publicado en: | International Journal of STD & AIDS Vol. 27; no. 2; pp. 110 - 118 |
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| Autores principales: | , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Sage Publications Inc.
Feb2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=111957746&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 111957746 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09564624 8O9 jtl: International Journal of STD & AIDS issn: 09564624 maglogo: Y pubinfo: dt: Feb2016 vid: 27 iid: 2 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 111957746 111957746 NLM25693580 111957746 10.1177/0956462415574633 NLM25693580 111957746 ppf: 110 ppct: 8 formats: tig: atl: Neuroimaging of HIV-associated cryptococcal meningitis: comparison of magnetic resonance imaging findings in patients with and without immune reconstitution. aug: au: Katchanov, Juri Branding, Gordian Jefferys, Laura Arastéh, Keikawus Stocker, Hartmut Siebert, Eberhard affil: Department of Infectious Diseases, Vivantes Auguste-Viktoria Klinikum, Berlin, Germany sug: subj: Meningitis, Cryptococcal Diagnosis Antiretroviral Therapy, Highly Active Adverse Effects Immune Reconstitution Inflammatory Syndrome Diagnosis HIV Infections Diagnosis AIDS-Related Opportunistic Infections Diagnosis Cryptococcus HIV Infections Complications Arachnoid Cysts Pathology Germany Neuroradiography Magnetic Resonance Imaging Fluconazole Therapeutic Use Female Antifungal Agents Therapeutic Use Meningitis, Cryptococcal Drug Therapy Anti-HIV Agents Therapeutic Use Male Immunocompromised Host AIDS-Related Opportunistic Infections Complications Immune Reconstitution Inflammatory Syndrome Drug Therapy Human Meningitis, Cryptococcal Complications Middle Age AIDS-Related Opportunistic Infections Drug Therapy Immune Reconstitution Inflammatory Syndrome Complications Adult Validation Studies Comparative Studies Evaluation Research Multicenter Studies Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: To determine the frequency, imaging characteristics, neuroanatomical distribution and dynamics of magnetic resonance imaging findings in HIV-associated cryptococcal meningitis in immunocompromised patients we compared patients without antiretroviral therapy with patients undergoing immune reconstitution. Neuroimaging and clinical data of 21 consecutive patients presenting to a German HIV centre in a 10-year period between 2005 and 2014 were reviewed. We identified eight patients with magnetic resonance imaging findings related to cryptococcal disease: five patients without antiretroviral therapy and three patients receiving effective antiretroviral therapy resulting in immune reconstitution. The pattern of magnetic resonance imaging manifestations was different in the two groups. In patients not on antiretroviral therapy, pseudocysts (n = 3) and lacunar ischaemic lesions (n = 2) were detected. Contrast-enhancing focal leptomeningeal and/or parenchymal lesions were found in all patients under immune reconstitution (n = 3). Magnetic resonance imaging lesions suggestive of leptomeningitis or meningoencephalitis were detected in all patients with a recurrence of cryptococcal meningitis under immune reconstitution, which differs from the classical magnetic resonance imaging findings in patients without antiretroviral therapy. In antiretroviral therapy-treated patients with past medical history of cryptococcal meningitis, detection of contrast-enhancing focal meningeal and/or parenchymal lesions should prompt further investigations for a recurrence of cryptococcal meningitis under immune reconstitution. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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