Table 2.
Neurologic and neuroimaging findings associated with selected parasitic CNS infections.
| Disease | Neurologic manifestations | Neuroimaging findings | Comments |
|---|---|---|---|
| Malaria | Coma, seizures, cranial nerve dysfunction, cognitive dysfunction; neurologic syndrome after malaria | Cerebral edema, multifocal cortical or subcortical lesions that may be enhanced after gadolinium administration, high signal intensity on diffusion- weighted imaging and decreased signal on apparent diffusion coefficient maps | Severe malaria is more common among HIV-infected people than others |
| Trypanosomiasis | Mental status changes and sleep, motor, and speech disturbances | Hypointensity of the basal ganglia | HIV-infected people have higher risk for treatment failure and worse outcome of both HAT and HIV; no posttransplantation cases have been reported |
| Microsporidiasis | Multifocal deficits; seizures are common | Multiple ring enhancing lesions that can involve grey and white matter | CNS infection occurs only during disseminated infection; in HIV-infected people, it is often accompanied by microsporidial sinusitis or keratoconjunctivitis |
| Leishmaniasis | Peripheral neuropathy, cranial nerve dysfunction, meningitis, optic nerve involvement, Guillain-Barre syndrome | Usually normal | CNS manifestations are uncommon regardless of host immune status; the most common neurologic manifestation of leishmaniasis is peripheral neuropathy |