PT - JOURNAL ARTICLE AU - Ionita, Catalina AU - Wasay, Mohammed AU - Balos, Lucia AU - Bakshi, Rohit TI - MR Imaging in Toxoplasmosis Encephalitis after Bone Marrow Transplantation: Paucity of Enhancement despite Fulminant Disease DP - 2004 Feb 01 TA - American Journal of Neuroradiology PG - 270--273 VI - 25 IP - 2 4099 - http://www.ajnr.org/content/25/2/270.short 4100 - http://www.ajnr.org/content/25/2/270.full SO - Am. J. Neuroradiol.2004 Feb 01; 25 AB - Summary: We present a patient who underwent bone marrow transplantation (BMT) after developing chronic myelocytic leukemia. Four months after BMT, he became comatose and died. MR imaging revealed multifocal brain lesions that were progressive but produced no edema. Postcontrast studies revealed that most of the lesions were nonenhancing. There was only discrete, irregular leptomeningeal enhancement with possible minimal enhancement of the cortex and subcortical white matter. Autopsy showed overwhelming toxoplasmosis encephalitis. This case illustrates that toxoplasmosis lesions may lack obvious contrast enhancement in the brain of the immunocompromised patients, despite severe involvement. Recognition of this unusual MR imaging manifestation of toxoplasmosis should lead to earlier diagnosis and treatment.