ArticlePLoS neglected tropical diseases2013
Cerebral toxoplasmosis mimicking subacute meningitis in HIV-infected patients; a cohort study from Indonesia.
Article in PLoS neglected tropical diseases, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- The Global Prevalence of and Factors Associated with Parasitic Coinfection in People Living with Viruses: A Systematic Review and Meta-Analysis.Pathogens (Basel, Switzerland) · 2025Pooled it
- Concurrent Tuberculous Meningitis and Toxoplasma Encephalitis in an HIV-Positive Patient: An Exceptionally Rare Case.Cureus · 2025Article
- Article
- Clinical Significance of Hyponatremia in Tuberculous Meningitis: A Prospective Cohort in Indonesia.Open forum infectious diseases · 2024Article
- Neuroimaging Patterns of Intracranial Infections: Meningitis, Cerebritis, and Their Complications.Neuroimaging clinics of North America · 2023Review
- Current Status of Parasite Infections in Indonesia: A Literature Review.The Korean journal of parasitology · 2019Review
- Advances and Challenges in Understanding Cerebral Toxoplasmosis.Frontiers in immunology · 2019Review
- Presentation, etiology, and outcome of brain infections in an Indonesian hospital: A cohort study.Neurology. Clinical practice · 2018Article
- Human Immunodeficiency Virus in the Brain-Culprit or Facilitator?Infectious diseases · 2018Review
- Caspase-11 Modulates Inflammation and Attenuates Toxoplasma gondii Pathogenesis.Mediators of inflammation · 2016Article
- Toxoplasma gondii meningoencephalitis without cerebral MRI findings in a patient with ulcerative colitis under immunosuppressive treatment.Infection · 2015Article
- Identification of functional modules of AKMT, a novel lysine methyltransferase regulating the motility of Toxoplasma gondii.Molecular and biochemical parasitology · 2013Article
- Article
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHIV-associated subacute meningitis is mostly caused by tuberculosis or cryptococcosis, but often no etiology can be established. In the absence of CT or MRI of the brain, toxoplasmosis is generally not considered as part of the differential diagnosis. METHODOLOGY/PRINCIPAL
findingsWe performed cerebrospinal fluid real time PCR and serological testing for Toxoplasma gondii in archived samples from a well-characterized cohort of 64 HIV-infected patients presenting with subacute meningitis in a referral hospital in Indonesia. Neuroradiology was only available for 6 patients. At time of presentation, patients mostly had newly diagnosed and advanced HIV infection (median CD4 count 22 cells/mL), with only 17.2% taking ART, and 9.4% PJP-prophylaxis. CSF PCR for T. Gondii was positive in 21 patients (32.8%). Circulating toxoplasma IgG was present in 77.2% of patients tested, including all in whom the PCR of CSF was positive for T. Gondii. Clinically, in the absence of neuroradiology, toxoplasmosis was difficult to distinguish from tuberculosis or cryptococcal meningitis, although CSF abnormalities were less pronounced. Mortality among patients with a positive CSF T. Gondii PCR was 81%, 2.16-fold higher (95% CI 1.04-4.47) compared to those with a negative PCR. CONCLUSIONS/SIGNIFICANCE: Toxoplasmosis should be considered in HIV-infected patients with clinically suspected subacute meningitis in settings where neuroradiology is not available.
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