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...

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Publicado en:International Journal of STD & AIDS Vol. 27; no. 2; pp. 110 - 118
Autores principales: Katchanov, Juri, Branding, Gordian, Jefferys, Laura, Arastéh, Keikawus, Stocker, Hartmut, Siebert, Eberhard
Formato: research Journal Article
Publicado: Sage Publications Inc. Feb2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2016
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        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
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