ZNS-Infektionen bei Immunsupprimierten

Stefan Weidauer; Elke Hattingen

doi:10.1055/a-0795-1816

Radiologie up2date, Table of Contents

Radiologie up2date 2019; 19(01): 39-58
DOI: 10.1055/a-0795-1816

Neuroradiologie

Georg Thieme Verlag KG Stuttgart · New York

ZNS-Infektionen bei Immunsupprimierten

CNS-Infections in Immunocompromised Individuals

Authors

Stefan Weidauer
Elke Hattingen

Abstract

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Zusammenfassung

Bei Immuninkompetenz ist das Erregerspektrum verändert und erweitert. Erreger, die bei Immunkompetenten keine Infektion auslösen können, müssen je nach Art der beeinträchtigten Immunabwehr berücksichtigt werden. Dementsprechend sind auch die Befunde in der zerebralen Bildgebung und in der Labor- und Liquordiagnostik verändert.

Abstract

The spectrum of CNS infections, the neurological aspects and the neuroradiological findings in immunocompromised patients differ from the immunocompetent ones and can be very variable. The differential diagnosis should include also rare and unusual infections. Therefore, it is essential to know what sort of patient has a disease. In addition, parenchymal reactions may occur as a result of inflammatory immune reconstitution syndrome when immune competence is restored.

Schlüsselwörter

ZNS-Infektion - Immunsuppression - opportunistische Infektion

Key words

infections of the central nervous system - immunosuppression - opportunistic infection

Full Text

References

Literatur
1 Schmutzhard E, Pfausler B. Infections of the central nervous system in immuno-compromised. Nervenarzt 2008; 79 Suppl 2: 93-108
2 Pruitt AA. Central nervous system infections complicating immunosuppression and transplantation. Continuum 2018; 24: 1370-1396
3 Williamson EM, Berger JR. Central nervous system infections with immunomodulatory therapies. Continuum 2015; 21: 1577-1598
4 Granerod J, Ambrose HE, Davies NWS. et al. Causes of encephalitis and differences in their clinical presentations in England: a multicenter, population-based prospective study. Lancet Infect Dis 2010; 10: 835-844
5 Kastrup O, Wanke I, Maschke M. Neuroimaging of infections of the central nervous system. Semin Neurol 2008; 28: 511-522
6 Tan K, Roda R, Ostrow L. et al. PML-IRIS in patients with HIV infection – Clinical manifestations and treatment with steroids. Neurology 2009; 72: 1458-1464
7 Gray F, Bazille C, Adle-Biassette H. et al. Central nervous system immune reconstitution disease in acquired immunodeficiency syndrome patients receiving highly active antiretroviral treatment. J Neurovirol 2005; 11 suppl 3: 16-22
8 Guggenberger K, Urbach H. MRT-Veränderungen bei Immunmodulation. Nervenarzt 2018; 89: 945-957
9 Hodel J, Darchis C, Outteryck O. et al. Punctate pattern – A promising imaging marker for the diagnosis of natalizumab-associated PML. Neurology 2016; 86: 1516-1523
10 Hinchey J, Chaves C, Appignani B. et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996; 334: 494-500
11 Bartynski WS. Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features. AJNR Am J Neuroradiol 2008; 29: 1036-1042
12 Bartynski WS. Posterior Reversible Encephalopathy Syndrome, Part 2: Controversies Surrounding Pathophysiology of Vasogenic Edema. AJNR Am J Neuroradiol 2008; 29: 1043-1049
13 Brady E, Parikh NS, Navi BB. et al. The imaging spectrum of posterior reversible encephalopathy syndrome: A pictorial review. Clinical Imaging 2018; 47: 80-89
14 Tan CS, Koralnik IJ. Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis. Lancet Neurol 2010; 9: 425-437
15 Egli A, Infanti L, Dumoulin A. et al. Prevalence of polyomavirus BK and JC infection and replication in 400 healthy blood donors. J Infect Dis 2009; 199: 837-846
16 Hua X, Boyle CP, Harezlak A. et al. the HIV Neuroimaging Consortium. Disrupted cerebral metabolite levels and lower nadir CD4 + counts are linked to brain volume deficits in 210 HIV-infected patients on stable treatment. Neuroimage Clin 2013; 3: 132-142
17 Berkefeld J, Enzensberger W, Lanfermann H. MRI in human immunodeficiency virus-associated cerebral vasculitis. Neuroradiology 2000; 42: 526-528
18 Gottumukkala RV, Romero JM, Riascos RF. et al. Imaging of the brain in patients with human immunodeficiency virus infection. Magn Reson Imaging 2014; 23: 275-291
19 Yousry TA, Pelletier D, Cadavid D. et al. Magnetic Resonance Imaging Pattern in Natalizumab-Associated Progressive Multifocal Leukoencephalopathy. Ann Neurol 2012; 72: 779-787
20 Maschke M, Dietrich U, Prumbaum M. et al. Opportunistic CNS infection after bone marrow transplantation. Bone Marrow Transplant 1999; 23: 1167-1176
21 Khalaf AM, Hashim MA, Alsharabati M. et al. Late-Onset Cerebral Toxoplasmosis After Allogeneic Hematopoietic Stem Cell Transplantation. Am J Case Rep 2017; 18: 246-250
22 Mele A, Paterson PJ, Prentice HG. et al. Toxoplasmosis in bone marrow transplantation: A report of two cases and systematic review of the literature. Bone Marrow Transplant 2001; 29: 691-698
23 Server A, Bargalló N, Floisand Y. et al. Imaging spectrum of central nervous system complications of hematopoietic stem cell and solid organ transplantation. Neuroradiology 2017; 59: 105-126
24 Shih RY, Koeller KK. Bacterial, fungal, and parasitic infections of the central nervous system: Radiologic-pathologic correlation and historical perspectives. Radiographics 2015; 35: 1141-1169
25 Luthra G, Parihar A, Nath K. et al. Comparative Evaluation of Fungal, Tubercular, and Pyogenic Brain Abscesses with Conventional and Diffusion MR Imaging and Proton MR Spectroscopy. AJNR Am J Neuroradiol 2007; 28: 1332-1338
26 Muftuoglu M, Olson A, Marin D. et al. Allogeneic BK Virus-Specific T Cells for Progressive Multifocal Leukoencephalopathy. N Engl J Med 2018; 379: 1443-1451
27 Bag AK, Cure JK, Chapman PR. et al. JC Virus Infection of the Brain. AJNR Am J Neuroradiol 2010; 31: 1564-1576
28 Nichtweiß M, Madlener J, Lang C. et al. Charakteristika der progressiven multifokalen Leukenzephalopathie (PML). Clin Neuroradiol 1994; 4: 185-195
29 Gheuens S, Wüthrich C, Koralnik IJ. Progressive multifocal leukoencephalopathy: why grey and white matter. Ann Rev Path 2013; 8: 189-215
30 Moll NM, Rietsch AM, Ransohoff AJ. et al. Cortical demyelination in PML and MS – Similarities and differences. Neurology 2008; 70: 336-343
31 Kuker W, Mader I, Nagele T. et al. Progressive multifocal leukoencephalopathy: value of diffusion-weighted and contrast-enhanced magnetic resonance imaging for diagnosis and treatment control. Eur J Neurol 2006; 13: 819-826
32 Buckle C, Castillo M. Use of Diffusion-Weighted Imaging to Evaluate the Initial Response of Progressive Multifocal Leukoencephalopathy to Highly Active Antiretroviral Therapy: Early Experience. AJNR Am J Neuroradiol 2010; 31: 1031-1035
33 Wattjes MP, Barkhof F. Diagnosis of natalizumab-associated progressive multifocal leukoencephalopathy using MRI. Curr Opin Neurol 2014; 27: 260-270
34 Wijburg MT, Witte BI, Vennegoor A. et al. MRI criteria differentiating asymptomatic PML from new MS lesions during natalizumab pharmacovigilance. J Neurol Neurosurg Psychiatr 2016; 87: 1138-1145
35 Franco-Paredes C, Womack T, Bohlmeyer T. et al. Management of Cryptococcus gattii meningoencephalitis. Lancet Infect Dis 2015; 15: 348-355
36 Palacios E, Rojas R, Rodulfa J. et al. Magnetic resonance imaging in fungal infections of the brain. Top Magn Reson Imaging 2014; 23: 199-212
37 Gaviani P, Schwartz RB, Hedley-Whyte ET. et al. Diffusion-Weighted Imaging of Fungal Cerebral Infection. AJNR Am J Neuroradiol 2005; 26: 1115-1121
38 Starkey J, Moritani T, Kirby P. MRI of CNS fungal infections: review of aspergillosis to histoplasmosis and everything in between. Clin Neuroradiol 2014; 24: 217-230
39 Gavito-Higuera J, Mullins CB, Ramos-Duran L. et al. Fungal Infections of the Central Nervous System: A Pictorial Review. J Clin Imaging Sci 2016; 17: 24
40 Marzolf G, Sabou M, Lannes B. et al. Magnetic Resonance Imaging of Cerebral Aspergillosis: Imaging and Pathological Correlations. PLoS One 2016;
41 Dubey A, Patwardhan RV, Sampath S. et al. Intracranial fungal granuloma: analysis of 40 patients and review of the literature. Surg Neurol 2005; 63: 254-260
42 Gärtner F, Forstenpointner J, Ertl-Wagner B. et al. CT and MRI Findings in Cerebral Aspergilloma. Rofo 2018; 190: 967-970
43 Seifried C, Weidauer S, Hinsch N. et al. Zerebrale lymphomatoide Granulomatose. Nervenarzt 2007; 78: 193-197
44 Haldorson IS, Espeland A, Larsson EM. Central Nervous System Lymphoma: Characteristic Findings on Traditional and Advanced Imaging. AJNR Am J Neuroradiol 2011; 32: 984-992
45 Schaller MA, Wicke F, Foerch C. et al. Central nervous system tuberculosis – etiology, clinical manifestations and neuroradiological features. Clin Neuroradiol 2019; 29: 3-18
46 Bernaerts A, Vanhoenacker FM, Parizel PM. et al. Tuberculosis of the central nervous system: overview of neuroradiological findings. Eur Radiol 2003; 13: 1876-1890
47 Weidauer S, Wagner M, Nichtweiß M. Magnetic Resonance Imaging and Clinical Features in Acute and Subacute Myelopathies. Clin Neuroradiol 2017; 27: 417-433
48 Berenguer J, Moreno S, Laguna F. et al. Tuberculous meningitis in patients infected with the human Immunodeficiency virus. N Engl J Med 1992; 326: 668-672
49 Chamie G, Marquez C, Luetkemeyer A. HIV-associated central nervous system tuberculosis. Semin Neurol 2014; 34: 103-115
50 Nagappa M, Sinha S, Taly AB. et al. Neurosyphilis: MRI features and their phenotypic correlation in a cohort of 35 patients from a tertiary care university hospital. Neuroradiology 2013; 55: 379-388
51 Gaa J, Weidauer S, Sitzer M. et al. Cerebral vasculitis due to treponema pallidum infection: MRI, MRA and DSA findings. Eur Radiol 2004; 14: 746-747
52 Bulakbasi N, Kocaoglu M. Central nervous system infections of herpesvirus family. Neuroimaging Clin North Am 2008; 18: 53-83
53 Modak J, Song X, Finelli P. et al. Herpes simplex encephalitis in an immunocompromised adult with novel MRI and pathology findings. Clin Neuroradiol 2017; 27: 231-234
54 Kelley BP, Patel SC, Marin HL. et al. Autoimmune Encephalitis: Pathophysiology and Imaging Review of an Overlooked Diagnosis. AJNR Am J Neuroradiol 2017; 38: 1070-1078
55 Demaerel P, Van Dessel W, Van Paesschen W. et al. Autoimmune-mediated encephalitis. Neuroradiology 2011; 53: 837-851
56 Graus F, Titulaer MJ, Balu R. et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 2016; 15: 391-404
57 Dubey D, Pittock SJ, Kelly CR. et al. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol 2018; 83: 166-177
58 Provenzale JM, van Landingham K, White LE. Clinical and imaging findings suggesting human herpesvirus 6 encephalitis. Pediatr Neurol 2010; 42: 32-39
59 Renard T, Daumas-Duport B, Auffray-Calvier E. et al. Cytomegalovirus encephalitis: Undescribed diffusion-weighted imaging characteristics. Original aspects of cases extracted from a retrospective study, and from literature review. J Neuroradiol 2016; 43: 371-377
60 Commins DL. Pathology of primary central nervous system lymphoma. Neurosurg Focus 2006; 2: E2
61 Kitajima M, Korogi Y, Shigematsu Y. et al. Central nervous system lesions in adult T-cell leukaemia: MRI and pathology. Neuroradiology 2002; 44: 559-567
62 Ascenção BB, Gonçalves AC, Luís N. et al. Epstein-Barr virus hemorrhagic meningoencephalitis: case report and review of the literature. J Neurovirol 2016; 22: 695-698
63 Brouwer MC, Coutinho JM, van de Beek D. Clinical characteristics and outcome of brain abscess: systematic review and meta-analysis. Neurology 2014; 82: 806-813