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1999, Number 1

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Enf Infec Microbiol 1999; 19 (1)

Cerebral toxoplasmosis in HIV-AIDS patients. A selective review

Soto HJL

Language: Spanish
References: 37
Page: 10-17
PDF size: 53.00 Kb.


ABSTRACT

Cerebral toxoplasmosis is the most common cause of focal brain lesions in patients with AIDS and it may occur in one third of AIDS patients who are seropositive for Toxoplasma gondii. In autopsy series the incidence of cerebral toxoplasmosis depends on the seroprevalence in the local population and it has been reported from 6 to 47%. Cerebral toxoplasmosis in our country can be the initial manifestation of AIDS. In some cases the clinical manifestations of cerebral toxoplasmosis may point to the diagnosis of AIDS in patients whose risk factors are unknown or unrecognized. Toxoplasmosis in the central nervous system usually develops by reactivation of a previously acquired infection that has remained latent in the form of encysted bradyzoites in the brain or other organs, until the appearance of severe immunosuppression. Brain toxoplasmosis is a life-threatening disease and without proper treatment rapidly fatal. The diagnosis is suspected by clinical manifestations and supported by imaging studies, CT or MRI of the brain. The use of polymerase chain reaction (PCR) has enabled detection of Toxoplasma gondii DNA in blood and cerebrospinal fluid (CSF) in some of this patients, nevertheless lumbar punctures are contraindicated in patients whose brain lesions produce mass effect. Most studies report a negative PCR 7 to 10 days after treatment. Up to 70% of the cases have a complete or partial response to specific therapy with a clear evidence of response in most cases on the first week.


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