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London F, Mulquin N, Ossemann M. Longitudinally extensive spinal cord lesion: keep toxoplasmosis in mind. Acta Neurol Belg 2023; 123:323-325. [PMID: 36622524 DOI: 10.1007/s13760-023-02184-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 01/05/2023] [Indexed: 01/10/2023]
Affiliation(s)
- Frédéric London
- Department of Neurology, Université Catholique de Louvain (UCLouvain), CHU UCL Namur, 1 Avenue G. Thérasse, 5530, Yvoir, Belgium.
| | - Nicolas Mulquin
- Department of Radiology, Université Catholique de Louvain (UCLouvain), CHU UCL Namur, Yvoir, Belgium
| | - Michel Ossemann
- Department of Neurology, Université Catholique de Louvain (UCLouvain), CHU UCL Namur, 1 Avenue G. Thérasse, 5530, Yvoir, Belgium
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2
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Lim EJ, Leong NWL, Ho CL. Distinguishing Intramedullary Spinal Cord Neoplasms from Non-Neoplastic Conditions by Analyzing the Classic Signs on MRI in the Era of AI. Curr Med Imaging 2021; 18:797-807. [PMID: 34856911 DOI: 10.2174/1573405617666211202102235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/23/2021] [Accepted: 10/10/2021] [Indexed: 11/22/2022]
Abstract
Intramedullary lesions can be challenging to diagnose given the wide range of possible pathologies. Each lesion has unique clinical and imaging features, which are best evaluated on magnetic resonance imaging. Radiological imaging is unique with rich, descriptive patterns and classic signs-which are often metaphorical. In this review, we present a collection of classic MRI signs, ranging from neoplastic to non-neoplastic lesions, within the spinal cord. The differential diagnosis (DD) of intramedullary lesions can be narrowed down by careful analysis of the classic signs and pattern of involvement in the spinal cord. Furthermore, the signs are illustrated memorably with emphasis on the pathophysiology, mimics and pitfalls. Artificial intelligence (AI) algorithms, particularly deep learning, have made remarkable progress in image recognition tasks. The classic signs and related illustrations can enhance a pattern recognition approach in diagnostic radiology. Deep learning can potentially be designed to distinguish neoplastic from non-neoplastic processes by pattern recognition of the classic MRI signs.
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Affiliation(s)
- Ernest Junrui Lim
- NUS Yong Loo Lin School of Medicine, NUHS Tower Block, 1E Kent Ridge Road, Level 11. Singapore
| | - Natalie Wei Lyn Leong
- NUS Yong Loo Lin School of Medicine, NUHS Tower Block, 1E Kent Ridge Road, Level 11. Singapore
| | - Chi Long Ho
- Sengkang General Hospital, 110, Sengkang Eastway . Singapore
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3
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Martinot M, Greigert V, Farnarier C, Dardé ML, Piperoglou C, Mohseni-Zadeh M, Tarabeux J, Guffroy A, Villard O, Vely F. Spinal cord toxoplasmosis in a young immunocompetent patient. Infection 2019; 48:299-302. [PMID: 31820319 DOI: 10.1007/s15010-019-01380-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/03/2019] [Indexed: 12/26/2022]
Abstract
We report a case of spinal cord toxoplasmosis occurring as a primary infection in a 31-year-old immunocompetent man. Exhaustive immunologic and genetic investigations did not identify any immunodeficiency. The causative agent was a typical type 2 strain. In cases of spinal cord lesions, toxoplasmosis should be considered, even in an immunocompetent patient.
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Affiliation(s)
- M Martinot
- Infectious and Tropical Diseases Department, Medecine E Hôpitaux Civils de Colmar, 39 Avenue de la liberté, 68024, Colmar, France.
| | - V Greigert
- Infectious and Tropical Diseases Department, Medecine E Hôpitaux Civils de Colmar, 39 Avenue de la liberté, 68024, Colmar, France.,Parasitology Department, Strasbourg University, Strasbourg, France
| | - C Farnarier
- APHM, Hôpital de la Timone, Service d'Immunologie, Marseille-Immunopole, Marseille, France
| | - M L Dardé
- Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France.,INSERM, Univ. Limoges, CHU Limoges, UMR 1094, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000, Limoges, France
| | - C Piperoglou
- APHM, Hôpital de la Timone, Service d'Immunologie, Marseille-Immunopole, Marseille, France
| | - M Mohseni-Zadeh
- Infectious and Tropical Diseases Department, Medecine E Hôpitaux Civils de Colmar, 39 Avenue de la liberté, 68024, Colmar, France
| | - J Tarabeux
- Laboratoires de Diagnostic Génétique, University Hospital of Strasbourg, Strasbourg, France
| | - A Guffroy
- National Referral Center for Systemic Autoimmune Diseases RESO, University Hospital of Strasbourg, Strasbourg, France.,Clinical Immunology and Internal Medicine, University Hospital of Strasbourg, Strasbourg, France
| | - O Villard
- Parasitology Department, Strasbourg University, Strasbourg, France
| | - F Vely
- APHM, Hôpital de la Timone, Service d'Immunologie, Marseille-Immunopole, Marseille, France.,Aix Marseille Univ, CNRS, INSERM, CIML, Marseille, France
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4
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De Clercq J, Crevits I, Reynders M, Deeren D. Toxoplasma gondii-induced brachial plexus neuropathy after allogeneic hematopoietic stem cell transplantation. Transpl Infect Dis 2019; 21:e13157. [PMID: 31394027 DOI: 10.1111/tid.13157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/13/2019] [Accepted: 07/28/2019] [Indexed: 11/26/2022]
Abstract
Brachial plexus neuropathy is a rare, but underdiagnosed condition, characterized by intense analgesic-resistant shoulder pain, followed by brachial plexus paresis and sensory symptoms. We present a case of brachial plexus neuropathy, induced by Toxoplasma gondii (T. gondii) 17 days after allogeneic hematopoietic stem cell transplantation (alloHSCT) in a patient with acute myeloid leukemia. The diagnosis was made based on the clinical presentation, magnetic resonance imaging (MRI) of the brachial plexus, and positive T. gondii polymerase chain reaction (PCR) in cerebrospinal fluid. The patient was treated with pyrimethamine, sulfadiazine, and levofolinic acid during 6 weeks, with a positive outcome.
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Affiliation(s)
| | - Ilse Crevits
- Department of Radiology, AZ Delta Roeselare, Roeselare, Belgium
| | | | - Dries Deeren
- Department of Hematology, AZ Delta Roeselare, Roeselare, Belgium
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