Complex diagnostic cases of cerebral toxoplasmosis in the practice of a neurosurgeon
https://doi.org/10.63769/1683-3295-2025-27-3-101-109
Abstract
Solitary forms of cerebral toxoplasmosis can mimic brain tumors, so sometimes such patients end up in neurosurgical hospitals. The situation becomes more complicated when the patient‘s HIV (human immunodeficiency virus) status is unknown, there is no history of drug addiction and there are no external manifestations of opportunistic infections. According to the literature, such patients are periodically operated on with a diagnosis of brain tumor.
This article presents three clinical cases of patients with cerebral toxoplasmosis who were treated in the neurosurgical department. Two of them had to undergo surgery due to a brain tumor, and one patient had to undergo surgery due to a temporal lobe abscess.
About the Authors
P. G. ShnyakinRussian Federation
1 Partizana Zheleznyaka St., Krasnoyarsk 1660022; 3a Partizana Zheleznyaka St., Krasnoyarsk 660022
A. V. Botov
Russian Federation
1 Partizana Zheleznyaka St., Krasnoyarsk 1660022; 3a Partizana Zheleznyaka St., Krasnoyarsk 660022
V. A. Khorzhevsky
Russian Federation
3a Partizana Zheleznyaka St., Krasnoyarsk 660022
A. S. Loseva
Russian Federation
Anastasia S. Loseva.
1 Partizana Zheleznyaka St., Krasnoyarsk 1660022
References
1. Olyushin V.E., Kiyashko S.S., Maslova L.N. et al. Toxoplasmosis of the brain in HIV infection: neurological and neurosurgical problems. Vestnik nevrologii, psikhiatrii i neyrokhirurgii =Bulletin of Neurology, Psychiatry, and Neurosurgery 2017;8:61–75. (In Russ.).
2. Kiiashko S.S., Maslova L.N., Ivanova N.E. Diagnostic difficulties in local brain lesion in patients with HIV-associated toxoplasmosis. Rossiyskiy zhurnal personalizirovannoy meditsiny = Russian Journal for Personalized Medicine 2022;2(5):25–37. (In Russ.). DOI: 10.18705/2782-3806-2022-2-3-25-37
3. Khoreva M.A., Afanasyeva A.I., Yelchaninova E.Yu., Sorokina E.A. Neurological masks of HIV infection. Mezhdunarodniy nauchnо-issledovatelskiy zhurnal = International Research Journal 2018;1(67):65–8. (In Russ.). DOI: 10.23670/IRJ.2018.67.042
4. Rapalino O., Mullins M.E. Intracranial infectious and inflammatory diseases presenting as neurosurgical pathologies. Neurosurgery 2017;81(1):10–28. DOI: 10.1093/neuros/nyx201
5. Graham A.K., Sharma S., Yamamura D. et al. Brain toxoplasmosis and bacterial infection after liver transplantation. Can J Neurol Sci 2023;50(1):155–7. DOI: 10.1017/cjn.2021.494
6. Dian S., Ganiem A.R., Ekawardhani S. Cerebral toxoplasmosis in HIV-infected patients: a review. Pathog Glob Health 2023;117(1):14–23. DOI: 10.1080/20477724.2022.2083977
7. Azovtseva O.V., Viktorovа E.A., Murochkin V.V. et al. Clinical and pathological manifestations of brain damage in HIV infection. VICH-infektsiya i immunosupressii = HIV Infection and Immunosuppressive Disorders 2019;11(3):37–48. (In Russ.). DOI: 10.22328/2077-9828-2019-11-3-37-48
8. Azovtseva O.V., Viktorova E.A., Bakulina E.G. et al. Cerebral toxoplasmosis in HIV-infected patients over 2015-2018 (a case study of Russia). Epidemiol Infect 2020;148:e142. DOI: 10.1017/S0950268820000928
9. Vidal J.E. HIV-related cerebral toxoplasmosis revisited: current concepts and controversies of an old disease. J Int Assoc Provid AIDS Care 2019;18:2325958219867315. DOI: 10.1177/2325958219867315
10. De Oliveira G.B., Lopes da Silva M.A., Wanderley L.B. Cerebral toxoplasmosis in patients with acquired immune deficiency syndrome in the neurological emergency department of a tertiary hospital. Clin Neurol Neurosurg 2016;150:23–6. DOI: 10.1016/j.clineuro.2016.08.014
11. Antinori A., Larussa D., Cingolani A. et al. Italian Registry Investigative NeuroAIDS. Prevalence, associated factors, and prognostic determinants of AIDS-related toxoplasmic encephalitis in the era of advanced highly active antiretroviral therapy. Clin Infect Dis 2004;39(11):1681–91. DOI: 10.1086/424877
12. Robert-Gangneux F., Dardé M.-L. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev 2012;25(2):264–96. DOI: 10.1128/CMR.05013-11
13. DiPellegrini G., Boccaletti R., Mingozzi A. et al. Single thalamic localization of brain toxoplasmosis mimicking brain tumors: radiological and clinical findings. Surg Neurol Int 2023;14:82. DOI: 10.25259/SNI_34_2023
14. Liang B., Yang S.-Y., Chen J.M. et al. Diagnostic value of real-time PCR of brain mass lesion in HIV-associated toxoplasmic encephalitis: a case series. Parasit Vectors 2020;13(1):564. DOI: 10.1186/s13071-020-04443-1
15. Schmidt A.R., Kurtasova L.M., Shulmin A.V. Chemoprophylaxis of Vertical Transmission of HIV Infection in the Krasnoyarsk Region. Sibirskoye meditsinskoye obozreniye = Siberian Medical Review 2015;1:90–4. (In Russ.).
Review
For citations:
Shnyakin P.G., Botov A.V., Khorzhevsky V.A., Loseva A.S. Complex diagnostic cases of cerebral toxoplasmosis in the practice of a neurosurgeon. Russian journal of neurosurgery. 2025;27(3):101-109. (In Russ.) https://doi.org/10.63769/1683-3295-2025-27-3-101-109