후천성 면역 결핍증 환자에서 발생한 뇌톡소플라즈마증 1례
A Case of Cerebral Toxoplasmosis in a Patient with Acquired Immune Defeciency Syndrome
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초록
뇌톡소플라즈마증은 후천성면역결핍증 환자에서 발생하는 중추신경계 기회감염증의 가장 흔한 원인 중 하나이다. 그 빈도는 지역마다 다양하지만 우리나라에서는 매우 드물게 보고되고 있다. 지금까지 우리나라에서 보고된 후천성면역결핍증 환자에서 발생한 뇌톡소플라즈마증 증례들은 모두 혈청학적으로 진단한 것으로 조직학적으로 증명된 경우는 없었다. 저자들은 HIV 감염 후 약 10년 동안 특별한 치료를 받지 않고 지내다 뇌의 다발성 종괴로 내원하여 조직학적으로 확진된 뇌톡소플라즈마증 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Toxoplasmosis is one of the most common opportunistic infection of the central nervous system in patients with acquired immunodeficiency syndrome(AIDS). There have been few reports of cerebral toxoplasmosis in patients with AIDS in Korea. In most cases, the diagnosis was assisted by serology and neuroradiologic findings. Making a reliable diagnosis of acute cerebral toxoplasmosis is difficult in patients with AIDS because of the lack of specificity of serologic data and neuroradiological findings. We report a case of 32-year-old man who presented with decreased mentality and fever. Brain MRI showed multiple ill-defined mass-like lesions in both basal ganglia and right thalamus. Stereotatic brain biopsy revealed small parasitic cysts which were filled with toxoplasmic bradyzoites in inflammatory brain tissue.
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