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April 2015; 2 (2) Clinical/Scientific NotesOpen Access

Varicella-zoster virus encephalitis mimicking toxoplasmosis relapse

Inês Brás Marques, Stuart Flanagan, Heather Noble, Gavin Giovannoni, Monica Marta
First published February 12, 2015, DOI: https://doi.org/10.1212/NXI.0000000000000074
Inês Brás Marques
From the Blizard Institute (I.B.M., G.G., M.M.), Queen Mary University London; and Barts Health NHS Trust (S.F., H.N.), London, UK.
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Stuart Flanagan
From the Blizard Institute (I.B.M., G.G., M.M.), Queen Mary University London; and Barts Health NHS Trust (S.F., H.N.), London, UK.
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Heather Noble
From the Blizard Institute (I.B.M., G.G., M.M.), Queen Mary University London; and Barts Health NHS Trust (S.F., H.N.), London, UK.
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Gavin Giovannoni
From the Blizard Institute (I.B.M., G.G., M.M.), Queen Mary University London; and Barts Health NHS Trust (S.F., H.N.), London, UK.
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Monica Marta
From the Blizard Institute (I.B.M., G.G., M.M.), Queen Mary University London; and Barts Health NHS Trust (S.F., H.N.), London, UK.
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Citation
Varicella-zoster virus encephalitis mimicking toxoplasmosis relapse
Inês Brás Marques, Stuart Flanagan, Heather Noble, Gavin Giovannoni, Monica Marta
Neurol Neuroimmunol Neuroinflamm Apr 2015, 2 (2) e74; DOI: 10.1212/NXI.0000000000000074

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    Figure Brain MRI of the patient throughout the disease course

    (A) Brain MRI at the time of cerebral toxoplasmosis diagnosis (a) and after 1 month of toxoplasmosis treatment (b). (B) Brain MRI at admission showing increase in lesion number and contrast uptake. (C) Brain MRI showing radiologic response to toxoplasmosis treatment. (D) Brain MRI after progressive clinical deterioration showing increase in lesion number and multiple new enhancing vessels in the perforator and peripheral distribution of middle cerebral artery territories. (E) Brain MRI after 2 months of foscarnet treatment. Despite significant clinical improvement, radiologic lesions persist.

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