Brain Biopsy

Toxoplasma encephalitis and PCNSL are the most common causes of CNS lesions in patients with AIDS. The differential diagnosis also includes fungal or atypical bacterial abscess, cryptococcoma, syphilitic gumma, tubercu-loma, cerebrovascular disease and neoplasm other than PCNSL [10]. Stereotactic brain biopsy (SBB) of a CNS lesion may be necessary under certain clinical scenarios: if a solitary CNS lesion is accompanied by negative toxoplasmosis serology; if a contrast-enhancing lesion is atypical for TE or does not respond to anti-toxoplasma treatment; if a new lesion develops during anti-toxoplasma maintenance treatment; or if histopathologic diagnosis is required for entry into an experimental treatment protocol [9]. If CNS herniation is imminent, open biopsy and decompression should be considered, unless the patient is terminal or has previously requested no intervention. Stereotactic brain biopsy provides a diagnosis for 88-98% of contrast-enhancing lesions and 67% of non-enhancing lesions [10]. Studies that examined the effect of SBB upon treatment and outcome of CNS disease noted that biopsy results did influence treatment [11,12]. In addition, life expectancy was increased in patients who underwent SBB when compared to patients who did not undergo SBB.

Complications of SBB occur in 3-12% of patients with HIV infection and are most often associated with hemorrhage, but may also include neurologic deficit, seizures or infection. Mortality occurred in 2-8% of patients [10]. These rates are slightly higher than those associated with stereotactic biopsy in people without HIV infection.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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