RESUMO
INTRODUCTION: Many clinical manifestations can be related to Tropheryma whipplei infection. CASE REPORT: We report a Tropheryma whipplei limbic encephalitis developed as a relapse of classical Whipple's disease. DISCUSSION: This case is to the best of our knowledge the first proof of the effective brain-blood barrier crossing of both doxycycline and hydroxychloroquine as demonstrated by direct concentration monitoring on brain biopsy.
Assuntos
Encefalite Límbica/diagnóstico , Tropheryma/isolamento & purificação , Doença de Whipple/diagnóstico , Biópsia , Cérebro/patologia , Humanos , Imuno-Histoquímica , Encefalite Límbica/microbiologia , Encefalite Límbica/patologia , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Recidiva , Doença de Whipple/complicações , Doença de Whipple/patologiaRESUMO
The incidence of HIV associated neurocognitive disorders (HAND) were reduced with the use of antiretroviral therapy. In case of neuropsychiatric symptoms, after elimination of all infections, auto-immune encephalitis could be evocated as a differential diagnosis. We describe a case of anti-N-Methyl-d-Aspartate receptor encephalitis in an HIV-1 infected woman.
Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/imunologia , Autoanticorpos/líquido cefalorraquidiano , Infecções por HIV/imunologia , HIV-1/fisiologia , Receptores de N-Metil-D-Aspartato/imunologia , Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Encefalite Antirreceptor de N-Metil-D-Aspartato/tratamento farmacológico , Ansiedade , Diagnóstico Diferencial , Eletrocardiografia , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Transtornos da Memória , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Distúrbios do Início e da Manutenção do SonoRESUMO
A 29-year-old kidney transplant recipient returning from Mali was diagnosed with Rift Valley fever (RVF) in France in autumn 2015. The patient was immunosuppressed due to his renal transplant. IgM and IgG specific to RVF virus (RVFV) were detected in cerebrospinal fluid and blood up to two months after symptom onset, whereas in urine, RVFV genomic RNA was detected by RT-PCR up to three months, and in semen up to four months post symptom onset.