Diagnostic difficulties in local brain lesion in patients with HIV-associated toxoplasmosis

Abstract

Toxoplasma gondii is a widespread parasitic infection, the activation of which is closely associated with the subsequent immune response. In HIV-infected patients, toxoplasmosis is one of the most common causes of brain damage, causing focal and cerebral symptoms, which can be difficult to diagnose, especially in cases where patients do not inform the doctor about HIV infection. The article presents clinical observations of patients with HIV-associated toxoplasmosis affecting the brain. Diagnostic difficulties arose due to the lack of reliable information about HIV infection in most patients. In the clinical picture, many patients had a multifocal brain lesion, which caused difficulties in recognizing the disease (metastases? encephalitis? Lymphoma?), and with an increase in hypertension-hypertension syndrome, an intracerebral tumor was assumed. To clarify the diagnosis, in case of detected volumetric brain lesions, surgical treatment was required, which was carried out in the volume of a stereotaxic biopsy in the compensated state of patients or emergency surgical intervention in decompensated patients to eliminate the dislocation syndrome.