TOXOPLASMOSIS

A 38 year old male with proven AIDS presents with headache, fever, nausea and confusion. He is immediately hospitalized and the following tests are done:

CSF shows 15 lymphocytes/ml, protein - 70 mg/dl, glucose 60 mg/dl

CT shows three ring-enhancing lesions with surrounding edema, located in the deep white matter of the frontal and parietal lobes

Chest X-ray shows no infiltrates.

Hgb 11.3gm/l, Hct 33.9%, WBC 3.800 with 79% neutrophils, 17% lymphocytes, 3% monocytes, platelets 163.000

Positive Sabin-Feldman dye test.

A brain biopsy is obtained and sent to the pathologist. The image below represents the biopsy:

(Note the cyst left and center of the slide.)

1. This patients diagnosis is:

A-Primary CNS lymphoma

B-Meningioma

C. Kaposi sarcoma

D-Meningoencephalitis

E-None of the above

Correct answer: D

2-The cause of this process is:

A-Monoclonal proliferation of B cells

B-Monoclonal proliferation of T cells

C-Proliferation of anaplastic glial cells

D-An infectious disease

E-None of the above

3-The following is/are true about this infection:

A-The causative agent is a protozoon

B-The definitive hosts are cats

C-Human infections are due to consumption of undercooked contaminated meat

D-Transplacental infections can occur

E-All of the above are true

Correct answer: E

4-Symptomatic infection is associated with:

A-AIDS

B-Immunosuppresive therapy

C-Malignant disease

D-Hodgkin’s lymphoma

E-All of the above

6-Congenital infection can produce:

A-Encephalitis

B-Microcephaly

C-Chorioretinitis

D-Mental retardation

E-All of the above

Correct answer: E