Abstract
Highly active antiretroviral therapy (HAART) has resulted in a reduction of morbidity and mortality in HIV-associated cerebral opportunistic infection. Before HAART, up to 50% of all HIV-infected patients in Europe developed cerebral toxoplasmosis, an encephalitis caused by reactivation of Toxoplasma gondii infection. Although potent therapeutical options exist, the prognosis is still poor. We describe the course of 36 AIDS patients with cerebral toxoplasmosis and present a review of clinical signs, diagnosis, therapy, and survival times. The main criteria for differential diagnosis from other secondary neuromanifestations such as primary CNS lymphoma, progressive multifocal leukencephalopathy, abscesses, and ischemic infarctions are described. Indications and problems of stereotactic biopsy are discussed.
MeSH terms
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AIDS-Related Opportunistic Infections / diagnosis*
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AIDS-Related Opportunistic Infections / drug therapy
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AIDS-Related Opportunistic Infections / mortality
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Acquired Immunodeficiency Syndrome / diagnosis
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Acquired Immunodeficiency Syndrome / drug therapy
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Adult
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Aged
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Antiretroviral Therapy, Highly Active
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Brain / pathology
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Dapsone / administration & dosage
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Diagnosis, Differential
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Diagnostic Imaging
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Drug Combinations
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Drug Therapy, Combination
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Female
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Follow-Up Studies
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Humans
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Male
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Middle Aged
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Pyrimethamine / administration & dosage
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Retrospective Studies
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Sulfadoxine / administration & dosage
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Survival Rate
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Toxoplasmosis, Cerebral / diagnosis*
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Toxoplasmosis, Cerebral / drug therapy
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Toxoplasmosis, Cerebral / mortality
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Trimethoprim, Sulfamethoxazole Drug Combination / administration & dosage
Substances
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Drug Combinations
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fanasil, pyrimethamine drug combination
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Trimethoprim, Sulfamethoxazole Drug Combination
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Sulfadoxine
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Dapsone
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Pyrimethamine