{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T19:17:49Z","timestamp":1783106269042,"version":"3.54.6"},"reference-count":3,"publisher":"Universidad Nacional de C\u00f3rdoba","issue":"2","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Fac Cien Med Univ Nac Cordoba"],"abstract":"<jats:p>A 73-year-old immunocompromised woman with a history of heart transplant presented with cognitive decline and left-sided neurological deficits. Imaging revealed atypical brain lesions. Initial biopsy was inconclusive. Despite extensive infectious workup, diagnosis remained unclear until a second brain biopsy confirmed central nervous system toxoplasmosis and cytomegalovirus (CMV) encephalitis. Treatment with antiparasitic and antiviral agents was initiated, but the patient\u2019s condition deteriorated, leading to palliative care. This case highlights diagnostic challenges in immunocompromised patients, the importance of considering atypical presentations of CNS infections, and the potential necessity of repeat biopsies when initial evaluations are non-diagnostic.<\/jats:p>","DOI":"10.31053\/1853.0605.v83.n2.48628","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:00:38Z","timestamp":1782846038000},"page":"e48628","source":"Crossref","is-referenced-by-count":0,"title":["A  double threat","Una doble amenaza","Uma  dupla amea\u00e7a"],"prefix":"10.31053","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1815-4149","authenticated-orcid":false,"given":"Salwa","family":"Alhammadi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2621-9929","authenticated-orcid":false,"given":"Tianyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9378-9025","authenticated-orcid":false,"given":"Aliya","family":"Szpindel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7874-9332","authenticated-orcid":false,"given":"M\u00e1rcio Lu\u00eds","family":"Duarte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6944-4978","authenticated-orcid":false,"given":"Leonardo Furtado","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"12333","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"1. Kastrup O, Wanke I, Maschke M. Neuroimaging of infections of the central nervous system. Semin Neurol. 2008 Sep;28(4):511-22. doi: 10.1055\/s-0028-1083688.","DOI":"10.1055\/s-0028-1083688"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2. Vidal JE, Rivero RLM, Dos Santos SS, Guedes BF, Gomes HR, Penalva de Oliveira AC, Garcia HH. Case Report: Calcified Cerebral Toxoplasmosis Associated with Perilesional Edema in People Living with HIV\/AIDS: Case Series of a Presentation Mimicking Neurocysticercosis. Am J Trop Med Hyg. 2022 Mar 7;106(5):1426-1433. doi: 10.4269\/ajtmh.21-1175.","DOI":"10.4269\/ajtmh.21-1175"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3. Chabaane M, Amelot A, Riche M, Bielle F, Mokhtari K, Carpentier A, Touat M, Mathon B. Efficacy of a Second Brain Biopsy for Intracranial Lesions after Initial Negativity. J Clin Neurol. 2020 Oct;16(4):659-667. doi: 10.3988\/jcn.2020.16.4.659.","DOI":"10.3988\/jcn.2020.16.4.659"}],"container-title":["Revista de la Facultad de Ciencias M\u00e9dicas de C\u00f3rdoba"],"original-title":[],"link":[{"URL":"http:\/\/revistas.unc.edu.ar\/index.php\/med\/article\/download\/48628\/54112","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/revistas.unc.edu.ar\/index.php\/med\/article\/download\/48628\/54113","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/revistas.unc.edu.ar\/index.php\/med\/article\/download\/48628\/54113","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T18:34:39Z","timestamp":1783103679000},"score":1,"resource":{"primary":{"URL":"http:\/\/revistas.unc.edu.ar\/index.php\/med\/article\/view\/48628"}},"subtitle":["CNS toxoplasmosis and CMV encephalitis in a heart transplant recipient","toxoplasmosis del SNC y encefalitis por CMV en un receptor detrasplante card\u00edaco","toxoplasmose do SNC e encefalite por CMV em um receptor de transplante card\u00edaco"],"short-title":[],"issued":{"date-parts":[[2026,6,26]]},"references-count":3,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6,30]]}},"URL":"https:\/\/doi.org\/10.31053\/1853.0605.v83.n2.48628","relation":{},"ISSN":["1853-0605","0014-6722"],"issn-type":[{"value":"1853-0605","type":"electronic"},{"value":"0014-6722","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,26]]}}}