| Cerebral toxoplasmosis complicating the acquired immune deficiency syndrome: clinical and neuropathological findings in 27 patients. | |
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MedLine Citation:
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PMID: 3963767 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We reviewed the clinical, neuroradiological, and serological findings in 27 patients with cerebral toxoplasmosis complicating the acquired immune deficiency syndrome, 19 of whom were also analyzed neuropathologically. The clinical manifestations of this disorder varied, ranging from headache and fever to coma. However, the characteristic presentation included focal neurological symptoms and signs, usually of subacute onset. In addition, two-thirds of the patients exhibited more generalized cerebral dysfunction with confusion and lethargy. The computed tomographic (CT) scan most commonly revealed ring contrast enhancement, which appeared to correlate best with the histological presence of vascular proliferation and inflammation surrounding the abscesses. However, in 5 patients the CT scan revealed either homogeneous enhancement or no enhancement, and in 3 patients the scans were negative. In general, CT scans underrepresented the number of lesions eventually documented pathologically. Double-dose contrast administration and preliminary experience with magnetic resonance imaging suggested that these techniques were superior to standard CT scanning in detecting Toxoplasma lesions. All patients were seropositive for IgG antibody against Toxoplasma gondii in blood, both before the onset of illness and at the time of presentation, although titers in some patients were as low as 1:8 and most patients did not exhibit rising titers. Prompt therapy resulted in rapid clinical improvement, documented by CT scan, associated with the development of an organizing tissue response in the host and elimination of free organisms. Response to treatment was sufficiently rapid in most patients to allow a trial of therapy as the favored approach to diagnosis. |
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Authors:
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B A Navia; C K Petito; J W Gold; E S Cho; B D Jordan; R W Price |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Annals of neurology Volume: 19 ISSN: 0364-5134 ISO Abbreviation: Ann. Neurol. Publication Date: 1986 Mar |
Date Detail:
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Created Date: 1986-04-28 Completed Date: 1986-04-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7707449 Medline TA: Ann Neurol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 224-38 Citation Subset: IM; X |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acquired Immunodeficiency Syndrome
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complications*,
pathology Adult Biopsy Brain Diseases / complications*, drug therapy, pathology, radiography Central Nervous System / pathology*, radiography Clindamycin / therapeutic use Humans Male Middle Aged Pyrimethamine / therapeutic use Serology Sulfonamides / therapeutic use Tomography, X-Ray Computed Toxoplasmosis / complications*, drug therapy, pathology, radiography |
| Chemical | |
Reg. No./Substance:
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0/Sulfonamides; 18323-44-9/Clindamycin; 58-14-0/Pyrimethamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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