Neurocysticercosis in the HIV era: a case report and review of the literature.
The prevalence of HIV is increasing in countries where neurocysticercosis is endemic. Co-infection rates are expected to rise; however, no systematic reviews of the subject are available. We performed a literature review of neurocysticercosis (NCC) occurring in HIV-infected patients and described the clinical and immunophenotypic characteristics of a NCC case presenting with probable immune reconstitution inflammatory syndrome. We identified 27 cases of NCC-HIV co-infection. The most frequent presentation (61%) was with multiple parenchymal lesions. Seven patients (30%) had other concomitant neurologic infections (e.g., tuberculosis, toxoplasmosis). Thirteen patients received cysticidal therapy, and 85% responded to therapy. Only three patients died (12%). Immunohistochemistry of brain tissue in our case revealed abundant CD3+, CD8+, and CD68+ cells. NCC should be included in the differential diagnosis of neurologic infections in HIV patients in endemic populations. Consideration of the patient's immune status should alert the clinician to potential atypical presentations.
Serpa
Jose A
JA
Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA.
Moran
Ana
A
Goodman
Jerry C
JC
Giordano
Thomas P
TP
White
A Clinton
AC
D000328:Adult; D018791:CD4 Lymphocyte Count; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D020019:Neurocysticercosis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D019562:Viral Load