Simultaneous Neurocysticercosis and Cerebral Toxoplasmosis in a Patient Living with HIV—Case Report

Background: Simultaneous central nervous system infection by more than one pathogen is very uncommon, even in individuals with acquired immunodeficiency syndrome. Purpose and methods: We report a clinical case of an HIV positive patient with simultaneous biopsy-confirmed neurotoxoplasmosis and neurocysticercosis. Results and conclusion: In this report, we present a rare occurrence of two simultaneous parasitic infections of the central nervous system in a patient with advanced immunosuppression due to HIV-1 infection. Despite the limited data available regarding the prevalence of such co-infections, this case underscores the importance of maintaining a high index of suspicion and promptly identifying concurrent neurologic diseases to enable accurate diagnosis and appropriate treatment in these patients.

SARS-CoV-2 involvement in central nervous system tissue damage

As the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)continues to spread globally,it became evident that the SARS-CoV-2 virus infects multiple organs including the brain.Several clinical studies revealed that patients with COVID-19 infection experience an array of neurological signs ranging in severity from headaches to life-threatening strokes.Although the exact mechanism by which the SARS-CoV-2 virus directly impacts the brain is not fully understood,several theories have been suggested including direct and indirect pathways induced by the virus.One possible theory is the invasion of SARS-CoV-2 to the brain occurs either through the bloodstream or via the nerve endings which is considered to be the direct route.Such findings are based on studies reporting the presence of viral material in the cerebrospinal fluid and brain cells.Nevertheless,the indirect mechanisms,including blood-clotting abnormalities and prolonged activation of the immune system,can result in further tissue and organ damages seen during the course of the disease.This overview attempts to give a thorough insight into SARS-CoV-2 coronavirus neurological infection and highlights the possible mechanisms leading to the neurological manifestations observed in infected patients.

Neurological diseases caused by coronavirus infection of the respiratory airways

Infections of the central nervous system(CNS)infections are critical problems for public health.They are caused by several different organisms,including the respiratory coronaviruses(Co Vs).Co Vs usually infect the upper respiratory tract causing the common cold.However,in infants,and in elderly and immunocompromised persons,they can also affect the lower respiratory tract causing pneumonia and various syndromes of respiratory distress.Co Vs also have neuroinvasive capabilities because they can spread from the respiratory tract to the CNS.Once infection begins in the CNS cells,it can cause various CNS problems such as status epilepticus,encephalitis,and long-term neurological disease.This neuroinvasive properties of Co Vs may damage the CNS as a result of misdirected host immune response,which could be associated with autoimmunity in susceptible individuals(virus-induced neuro-immunopathology)or associated with viral replication directly causing damage to the CNS cells(virus-induced neuropathology).In December 2019,a new disease named COVID-19 emerged which is caused by Co Vs.The significant clinical symptoms of COVID-19 are related to the respiratory system,but they can also affect the CNS,causing acute cerebrovascular and intracranial infections.We describe the possible invasion routes of coronavirus in this review article,and look for the most recent findings associated with the neurological complications in the recently published literature.