A 40 year old AIDS patient with CD4 count of 95 presents with a headache, confusion, and fever. A T1-weighted MRI with gadolinium is shown above.Challenge: What's the diagnosis?
Image shown under fair use.
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I put together these medical challenges. The cases are hypothetical and do not necessarily represent actual or typical presentations of medical diseases. Disclaimer is at the bottom of this page.
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4 comments:
cryptococcus?
toxoplasma gondii
Steph > Alex :P.
Crypto is an opportunistic CNS infection but it causes a meningoencephalitis. According to UpToDate, "Mass lesions in the CNS due to C. neoformans are so rarely seen in patients with HIV infection that coincident diagnoses such as toxoplasmosis, lymphoma, tuberculosis and syphilis should be considered."
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Toxic
This is toxoplasma encephalitis which occurs in AIDS patients with CD4 count < 100. The causative organism is the intracellular protozoan parasite Toxoplasma gondii. The image shows multiple ring enhancing lesions with mass effect, suggesting toxoplasmosis (other things on the differential include primary CNS lymphoma, TB, neurocystercerosis).
Source: UpToDate.
oh nuts.. knew it was "ring enhancing lesions" but mixed up the bug
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