Case Report: Calcified Cerebral Toxoplasmosis Associated with Perilesional Edema in People Living with HIV/AIDS: Case Series of a Presentation Mimicking Neurocysticercosis

José E. Vidal Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil;
Divisão de Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;
LIM 49, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;

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René L. M. Rivero Setor de Radiologia, Divisão de Apoio ao Diagnóstico e Terapêutica, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil;

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Sigrid de Sousa dos Santos Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, Brazil;

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Bruno F. Guedes Departmento de Neurologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil;

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Hélio R. Gomes Departmento de Neurologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil;
LIM 14, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;

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Augusto C. Penalva de Oliveira Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil;

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Hector H. Garcia Centro de Salud Global, Universidad Peruana Cayetano Herédia, Lima, Peru;
Unidad de Cisticercosis, Instituto de Ciencias Neurológicas, Lima, Peru

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ABSTRACT.

Perilesional edema, associated or not with neurological manifestations, is a well-characterized finding in cases of calcified neurocysticercosis. There are no previous reports of HIV-related calcified toxoplasmosis that mimics this presentation of neurocysticercosis. We report on five patients, four of them with new-onset neurological manifestations, who showed brain calcifications associated with perilesional edema. All cases had a history of HIV-related toxoplasmosis and current virological and immunological control of HIV infection. Similar to neurocysticercosis, brain calcified toxoplasmosis may cause perilesional edema and symptoms in people living with HIV/AIDS.

Author Notes

Address correspondence to José E. Vidal, LIM 49, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, Avenida Dr. Enéas de Carvalho de Aguiar, 470 - CEP 05403-000, São Paulo, Brazil. E-mail: josevibe@gmail.com

Authors’ addresses: José E. Vidal, Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, Divisão de Moléstias Infecciosas, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, and LIM 49, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mail: josevibe@gmail.com. René L. M. Rivero, Setor de Radiologia, Divisão de Apoio ao Diagnóstico e Terapêutica, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, E-mail: reneleandro3@hotmail.com. Sigrid de Sousa dos Santos, Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, Brazil, E-mail: sigridsantos@gmail.com. Bruno F. Guedes, Departmento de Neurologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, E-mail: bruno.guedes@hc.fm.usp.br. Hélio R. Gomes, Departmento de Neurologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, and LIM 14, Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, E-mail: helio.gomes@hc.fm.usp.br. Augusto C. Penalva de Oliveira, Departamento de Neurologia, Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, E-mail: rdcassia@uol.com.br. Hector H. Garcia, Centro de Salud Global, Universidad Peruana Cayetano Herédia, Lima, Peru, and Unidad de Cisticercosis, Instituto de Ciencias Neurológicas, Lima, Peru, E-mail: hhgarcia1@jhu.edu.

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