Repro Flashcards
Toxoplasmosis presentation HIV
50% of cerebral lesions in patients with HIV
headache, confusion, drowsiness
Toxoplasmosis investigation
CT: usually single or multiple ring enhancing lesions, mass effect may be seen
Toxoplasmosis management
sulfadiazine and pyrimethamine
2nd most common type of HIV focal brain lesions
CNS lymphoma
CNS lymphoma HIV association
associated with the Epstein-Barr virus
CNS lymphoma HIV investigation
CT: single lesion
homogenous throughout enhancing lesions
CNS lymphoma HIV treatment
steroids (may significantly reduce tumour size), chemotherapy (e.g. methotrexate)
+/- radiation
Surgical may be considered for lower grade tumours
Which focal neuro HIV lesion is thallium SPECT negative and which positive?
toxoplasmosis negative
CNS lymphoma positive
focal TB lesion HIV imaging?
CT: single enhancing lesion
encephalitis in HIV
may be due to CMV or HIV itself
HSV encephalitis but is relatively rare in the context of HIV
CT: oedematous brain
most common CNS fungal infection in HIV
cryptococcal
headache, fever, malaise, nausea/vomiting, seizures, focal neurological deficit
CSF in cryptococcal CNS infection
high opening pressure
elevated protein
reduced glucose
normally a lymphocyte predominance but in HIV white cell count many be normal
India ink test positive
Progressive multifocal leukoencephalopathy (PML)
widespread DEMYELINATION
JC virus
SUBACUTE onset : behavioural changes, speech, motor, visual impairment
CT: single or multiple lesions, no mass effect, don’t usually enhance.
MRI is better - high-signal demyelinating white matter lesions are seen
Herpes in pregnancy
if <28 weeks, treat with aciclovir then give aciclovir from 36 weeks to delivery
if >28 weeks, aciclovir till birth and planned c-section
