Clinical presentation, management, and outcome of suspected central nervous system infections in Indonesia: a prospective cohort study

Journal article

Background: Toxoplasmic encephalitis is a severe manifestation of Toxoplasma gondii infection, with potentially fatal outcomes, particularly among immunocompromised patients. Clinical manifestation of this infection is associated with a specific genotype of T. gondii, requiring the use of genetic marker for genotype determination. Aims: This study critically evaluated the application of GRA6 gene as genetic marker for genotyping T. gondii in cerebrospinal fluid (CSF) samples from HIV/AIDS patients diagnosed with Toxoplasmic encephalitis. Methods: The study analyzed 69 CSF samples from HIV/AIDS patients with Toxoplasmic encephalitis. These samples tested positive for Toxoplasma IgG serology and SAG2 PCR, while GRA6 genotyping was conducted using PCR-sequencing methods. Results: The results showed that GRA6 had potential for genotyping in positive control settings from culture cells. However, there was limited effectiveness in CSF samples from Toxoplasmic encephalitis patients. Conclusion: GRA6 had been proven effective as a genetic marker for the identification of T. gondii genotype among HIV/AIDS patients with Toxoplasmic encephalitis. However, the evaluation of GRA6 showed more effectiveness in cultured cells compared to direct clinical samples, such as cerebrospinal fluid obtained from HIV/AIDS patients with Toxoplasmic encephalitis.

Authors: Maharani, K; Dian, S; Ganiem, AR; Imran, D; Estiasari, R

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Springer
• Journal: Infection
• Volume: 52
• Issue: 2
• Pages: 583-595
• Publication date: 2024-02-05
• DOI: 10.1007/s15010-023-02170-0
• EISSN: 1439-0973
• ISSN: 0300-8126
• Language: English
• Keywords: Neurosyphilis; Disease; Syphilis; Tuberculosis; Pathology; Prospective cohort study; Etiology; Pediatrics; Cohort study; Cohort; Medicine; Internal medicine; Immunology; Meningitis; Human immunodeficiency virus (HIV)