[Recurrence of cerebral toxoplasmosis in 15 AIDS patients].
Relapse of brain toxoplasmosis in AIDS patients continue to occur despite maintenance therapy. The characteristics of 15 patients who experienced a relapse were reviewed. Mean delay of relapse was 7 months (2-20). Maintenance therapy for the 2 months prior to the relapse was pyrimethamine alone (n = 4), pyrimethamine plus dapsone (n = 3), pyrimethamine plus spiramycine (n = 1), pyrimethamine plus clindamycine (n = 4), pyrimethamine plus sulfadiazine (n = 1) and no treatment (n = 2). Strict compliance was ascertained for only 5 patients. Compared with the first episode of brain toxoplasmosis, all 15 patients had new neurological signs, and new lesions of the brain were detected by CT scan in 67% patients. This study showed that poor compliance to maintenance therapy is a major factor of relapse, and the less favourable response to acute therapy could be due to progression of immunodeficiency.
Walckenaer
G
G
Service des Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude-Bernard, Paris.
Leport
C
C
Longuet
P
P
Perronne
C
C
Lacassin
F
F
Vildé
J L
JL
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000382:microbiology; D002981:Clindamycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011739:Pyrimethamine / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D013411:Sulfadiazine / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016781:Toxoplasmosis, Cerebral / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000382:microbiology
D013411:Sulfadiazine; D002981:Clindamycin; D011739:Pyrimethamine
Rechutes de toxoplasmose cérébrale chez 15 malades atteints de SIDA.