title: Spinal cord toxoplasmosis in human immunodeficiency virus infection/acquired immunodeficiency syndrome.
abstract: Neurological complications in patients with human immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) are still common, even in the era of highly active antiretroviral therapy. Opportunistic infections, immune reconstitution, the virus itself, antiretroviral drugs and neurocognitive disorders have to be considered when establishing the differential diagnosis. Toxoplasmic encephalitis remains the major cause of space-occupying lesions in the brain of patients with HIV/AIDS; however, spinal cord involvement has been reported infrequently. Here, we review spinal cord toxoplasmosis in HIV infection and illustrate the condition with a recent case from our hospital. We suggest that most patients with HIV/AIDS and myelitis with enhanced spine lesions, multiple brain lesions and positive serology for Toxoplasma gondii should receive immediate empirical treatment for toxoplasmosis, and a biopsy should be performed in those cases without clinical improvement or with deterioration.
authors.affiliation: From the Departamento de Enfermedades Infecciosas, Hospital San Pedro - Centro de investigación Biomédica de la Rioja (CIBIR) , Logroño, La Rioja , Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: García-García
authors.forename: Federico
authors.initials: F
authors.lastname: Castillo-Álvarez
authors.forename: José M
authors.initials: JM
authors.lastname: Azcona-Gutiérrez
authors.forename: María J
authors.initials: MJ
authors.lastname: Herraiz
authors.forename: Valvanera
authors.initials: V
authors.lastname: Ibarra
authors.forename: José A
authors.initials: JA
authors.lastname: Oteo
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D023241:Antiretroviral Therapy, Highly Active; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009187:Myelitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D009422:Nervous System Diseases / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology; D014122:Toxoplasma / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016781:Toxoplasmosis, Cerebral / Q000150:complications / Q000175:diagnosis / Q000628:therapy
keywords: AIDS; HIV; myelitis; spinal cord disease; toxoplasmosis