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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.

Received March 15, 2007. Accepted for publication April 4, 2007.

Financial support: This work was supported in part by the facilities and resources of the Harris County Hospital District, Houston, TX.

Disclaimer: None of the authors report any conflict of interests.

^* Address correspondence to A. Clinton White Jr., Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical Branch at Galveston, 301 University Blvd., Route 0435, Galveston, TX 77555-0435. E-mail: acwhite{at}utmb.edu

Authors’ addresses: Jose A. Serpa, Department of Internal Medicine, Section of Infectious Diseases, Baylor College of Medicine, One Baylor Plaza, Mail Stop BCM286, Houston, TX 77030, Telephone: 713-798-8918, Fax: 713-798-8948, E-mail: jaserpaa{at}bcm.tmc.edu. Ana Moran, Department of Internal Medicine, Section of Infectious Diseases, Baylor College of Medicine, One Baylor Plaza, Mail Stop BCM286, Houston, TX 77030, Telephone: 713-798-4252, Fax: 713-798-8948, E-mail: amoran{at}bcm.tmc.edu. Jerry C. Goodman, Department of Pathology, Baylor College of Medicine, One Baylor Plaza, Mail Stop BCM315. Houston, TX 77030, Telephone: 713-798-7234, Fax: 713-798-5838, E-mail: jgoodman{at}bcm.tmc.edu. Thomas P. Giordano, Department of Internal Medicine, Section of Infectious Diseases, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, Telephone, 713-794-8682, Fax: 713-748-7359, E-mail: tpg{at}bcm.tmc.edu. A. Clinton White Jr., Department of Internal Medicine, Division of Infectious Diseases, University of Texas Medical Branch at Galveston, 301 University Blvd., Route 0435, Galveston, TX 77555-0435, Telephone: 409-747-1910, Fax: 409-772-6527, E-mail: acwhite{at}utmb.edu.

This article has been cited by other articles:

				L. Rangel-Castilla, J. A. Serpa, S. P. Gopinath, E. A. Graviss, P. Diaz-Marchan, and A. C. White Jr Contemporary Neurosurgical Approaches to Neurocysticercosis Am J Trop Med Hyg, March 1, 2009; 80(3): 373 - 378. [Abstract] [Full Text] [PDF]