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  #1  
Old 03-13-2013
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Neuro CNS Infection and Brain Biopsy in HIV

A 32-year-old woman who is seropositive for HIV is admitted to the hospital because of increasing confusion. She dies 2 days later. A tissue section of the meninges obtained at autopsy is shown. Which of the following is the most likely causal organism?

A. Candida albicans
B. Cryptococcus neoformans
C. Mycobacterium avium-intracellulare
D. Pneumocystis jiroveci (formerly P. carinii)
E. Toxoplasma gondii

CNS Infection and Brain Biopsy in HIV-000.jpg
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  #2  
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B ?
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B. Cryptococcus Neoformans ???
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Toxo/ E?

Ring enhancing lesions???
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Quote:
Originally Posted by mdsoon View Post
Toxo/ E?

Ring enhancing lesions???
I was thinking the same in the beginning but don't know what made me choose B later.

I thought we can see enhancing lesions in Cryptococcus as well.

Let wait and see.
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jhadshdaj

i was more inclined to pick cryptococus but ended of picking toxo cause i was looking at the lesions at 12 o'clock and 4 o'clock...

just did a google search of images of both.

turns out that the lesion looks more like cryptococus than toxo on histo slides.

so i pick B this time.
haha
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Old 03-13-2013
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Quote:
Originally Posted by mdsoon View Post
jhadshdaj

i was more inclined to pick cryptococus but ended of picking toxo cause i was looking at the lesions at 12 o'clock and 4 o'clock...

just did a google search of images of both.

turns out that the lesion looks more like cryptococus than toxo on histo slides.

so i pick B this time.
haha
Also can we reason that toxo won't be so aggressive and neoformans can cause meningitis and can be very aggressive?
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Old 03-13-2013
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Ill pick B

Ring enhacing lesions r a feature seen on radiographic imaging.. I dont think we can use the term on histo slides.. Or can we?!
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^ yes you make a valid point. i would like to know if you can see these lesions on histo slides..


either way..


author post the answer when you get a chance.
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Quote:
Originally Posted by mdsoon View Post
^ yes you make a valid point. i would like to know if you can see these lesions on histo slides..


either way..


author post the answer when you get a chance.
I think b is correct.
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Quote:
Originally Posted by Evergreen View Post
I think b is correct.
You think or you sure ?
Can you please make sure...I see questions whose answers are controversial on my exam..lolz
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Quote:
Originally Posted by Doc4Step1 View Post
You think or you sure ?
Can you please make sure...I see questions whose answers are controversial on my exam..lolz
i'm not sure...
This is a nbme question.
http://www.usmleforum.com/archives/2006/1/94922.php
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Quote:
Originally Posted by Evergreen View Post
i'm not sure...
This is a nbme question.
http://www.usmleforum.com/archives/2006/1/94922.php
Ok ..Thanks
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definitely cryptococcus
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Everything is possible for him who believes (MARK 9:23)
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Default B

B.Cryptococcus neoformans

Meningitis caused by opportunistic infection of C.neoformans.

C.neoformans has distinct polysaccharide capsule.
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B.....definitely
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Microbiology-, Micrographs-, Nervous-System-, Pathology-, Step-1-Questions

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