Encephalitis is inflammation of the brain. It can be caused by infection but the word does not actually describe infection per se.
My teaching (in radiology) was HIV > toxoplasmosis > cryptococcosis for CNS infections in HIV+ but maybe we're out of date or this order is sepcific to the US/Canadian population.
Anecdotally I've definitely seen more toxo than crypto. I've also seen more white matter disease in HIV patients than either but the MRI findings aren't specific so I don't know what the final path was on those cases.
PO amphotericin B would be a huge boon in treating these patients and shortening hospital stays. Outpatient Ampho B is not a good option in most cases.
> In our HIV patients we see more more cryptococcal meningitis than CNS toxoplasmosis. Crypto is typically not going to have any significant radiologic abnormality unlike toxo in which imaging plays a large role in diagnosis. So I'm guessing, being a radiologist, you've got a sampling bias that favors toxo.
Agree crypto is much more subtle on imaging than either HIV encephalitis or toxo, the most common finding we see is dilated PVS which is nonspecific (particularly without priors). I only mentioned my anecdotal experience as it corresponds with what's taught to us but I agree it's highly susceptible to bias and I don't consider it evidence.
For example on StatDx (UpToDate for radiologists):
>[Cryptococcus is the] most common fungal infection in AIDS patients
>3rd most common [CNS] infection seen in AIDS patients (HIV > toxoplasmosis > Cryptococcus)
This could very well be out of date/incorrect, they don't give in-text citations like UpToDate so I'm not sure where these specific statements are coming from.
Do you have a reference handy? If so I can submit it as feedback on the article to get it updated/reviewed.
Thanks for taking the time to search and comment. Always appreciate learning from my clinical colleagues + now I can flex a new obscure fact to radiology trainees like a proper academic physician.