title: [Cerebral toxoplasmosis and AIDS in Martinique].
abstract: This study was carried out in 60 AIDS patients who presented toxoplasma encephalitis in Martinique (French West Indies). Diagnosis was based on a combination of fever, neurologic signs, and characteristic CT-scan images in patients with positive HIV serology. There were 46 males and 14 females with a mean age of 40 years. The mode of transmission was heterosexual in most cases (68.3%). The incidence of drug-related transmission was low (6.7%). Neurotoxoplasmosis was the most frequent presenting symptom of AIDS (53.3%) followed by esophageal candidosis (20%) and pneumocystosis (10%). Clinical symptoms were headache (56.5%), fever (48.3%), hemiparesia (36.6%), and confusion (36.6%). CT-scan showed most lesions to be multiple (70%), hypodense (89%), and subject to contrast uptake (93%). Mean lymphocyte level was 1128/mm3 with 88 CD4/mm3 and a CD4-to-CD8 ratio of 0.14. Conventional treatment using a combination of pyrimethamine and sulfadiazine led to skin rash and neutropenia and had to be discontinued in 30% of cases. Clinical symptoms and mean survival (327 days) were the same as comparable findings from Europe and North America.
authors.affiliation: Département des Maladies Parasitaires et Tropicales, Hôpital Bicêtre, Kremlin-Bicêtre, France.
authors.forename: P
authors.initials: P
authors.lastname: Bourée
authors.forename: D
authors.initials: D
authors.lastname: Dumazedier
authors.forename: C
authors.initials: C
authors.lastname: Magdeleine
authors.forename: G
authors.initials: G
authors.lastname: Sobesky
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission; D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008395:Martinique; D008875:Middle Aged; D011739:Pyrimethamine / Q000627:therapeutic use; D012307:Risk Factors; D012725:Sexual Behavior; D013411:Sulfadiazine / Q000627:therapeutic use; D016019:Survival Analysis; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission
chemical_list: D000890:Anti-Infective Agents; D013411:Sulfadiazine; D005492:Folic Acid; D011739:Pyrimethamine
vernacular_title: Toxoplasmose cérébrale et SIDA à la Martinique.