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HIV Encephalitis: Atypical Biopsy for a Typical Presentation
Author(s) -
Chapman Sherita Nicole,
Kurukumbi Mohankumar,
Adams Alice,
JayamTrouth Annapurni
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.1001.14
Subject(s) - medicine , brain biopsy , biopsy , pathology , stereotactic biopsy , histopathology , encephalitis , neuropathology , dermatology , disease , virus , virology
Background Human Immunodeficiency Virus is neurotropic; approximately two‐thirds of patients with HIV infection will develop central nervous involvement during the course of their disease. Biopsy is still considered the gold standard in diagnosing cranial lesions in HIV patients. Case Presentation 36 year old male, with a history of HIV infection and recent CD4 count of 65, presented with complaints of weakness and numbness over left face and difficulty speaking for the four days. Clinical examination was normal except for mild flattening of the left nasolabial fold and decreased perception of pain and touch on left side of the face. Imaging revealed a right lateral frontal homogeneous enhancing lesion with surrounding edema. A craniotomy with biopsy was performed. Histopathology revealed acute and chronic vasculitis with focal tissue vacuolization, reactive gliosis and astrocytosis, consistent with HIV encephalitis. Special stains for fungi and Toxoplasma gondii were negative and there was no evidence of neoplasm. Conclusion This case report emphasizes the persisting challenge in evaluating cranial lesions in patients with HIV infection, including the gold standard brain biopsy.