{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:53:42Z","timestamp":1788170022375,"version":"build-2803163510"},"reference-count":67,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: It is unclear whether patients with basal ganglia calcifications (BGC) should undergo infectious disease testing as part of their diagnostic work-up. We investigated the occurrence of possibly associated infections in patients with BGC diagnosed with Fahr\u2019s disease or syndrome and consecutively performed a systematic review of published infectious diseases associated with BGC. Methods: In a cross-sectional study, we evaluated infections in non-immunocompromised patients aged \u2265 18 years with BGC in the Netherlands, who were diagnosed with Fahr\u2019s disease or syndrome after an extensive multidisciplinary diagnostic work-up. Pathogens that were assessed included the following: Brucella sp., cytomegalovirus, human herpesvirus type 6\/8, human immunodeficiency virus (HIV), Mycobacterium tuberculosis, rubella virus, and Toxoplasma gondii. Next, a systematic review was performed using MEDLINE and Embase (2002\u20132023). Results: The cross-sectional study included 54 patients (median age 65 years). We did not observe any possible related infections to the BGC in this population. Prior infection with Toxoplasma gondii occurred in 28%, and in 94%, IgG rubella antibodies were present. The positive tests were considered to be incidental findings by the multidisciplinary team since these infections are only associated with BGC when congenitally contracted and all patients presented with adult-onset symptoms. The systematic search yielded 47 articles, including 24 narrative reviews\/textbooks and 23 original studies (11 case series, 6 cross-sectional and 4 cohort studies, and 2 systematic reviews). Most studies reported congenital infections associated with BGC (cytomegalovirus, HIV, rubella virus, Zika virus). Only two studies reported acquired pathogens (chronic active Epstein\u2013Barr virus and Mycobacterium\u00a0tuberculosis). The quality of evidence was low. Conclusions: In our cross-sectional study and systematic review, we found no convincing evidence that acquired infections are causing BGC in adults. Therefore, we argue against routine testing for infections in non-immunocompromised adults with BGC in Western countries.<\/jats:p>","DOI":"10.3390\/jcm13082365","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T10:30:52Z","timestamp":1713436252000},"page":"2365","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Infectious Diseases and Basal Ganglia Calcifications: A Cross-Sectional Study in Patients with Fahr\u2019s Disease and Systematic Review"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3605-2289","authenticated-orcid":false,"given":"Birgitta M. G.","family":"Snijders","sequence":"first","affiliation":[{"name":"Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike J. L.","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"},{"name":"Department of Internal Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"van den Brink","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, ZorgSaam Hospital, 4535 PA Terneuzen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marijke J. C. A.","family":"van Trijp","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Groene Hart Ziekenhuis, 2803 HH Gouda, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim A.","family":"de Jong","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurens A. T. M.","family":"Vissers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frans M.","family":"Verduyn Lunel","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marielle H.","family":"Emmelot-Vonk","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0938-6232","authenticated-orcid":false,"given":"Huiberdina L.","family":"Koek","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jchemneu.2016.07.008","article-title":"Age and gender related prevalence of intracranial calcifications in CT imaging; data from 12,000 healthy subjects","volume":"78","author":"Yalcin","year":"2016","journal-title":"J. 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