title: [The colorful clinical spectrum of cerebral toxoplasmosis in five HIV positive cases: what comes out of Pandora's box?].
abstract: In patients with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), the most common cause of focal intracranial lesion is Toxoplasma gondii infection. T. gondii encephalitis is an easily and effectively treatable disease, with promising outcomes. T. gondii has the potential to form a focal infection niche anywhere in the central nervous system, thus allowing for a colorful clinical picture. In this report, we attempted to present five HIV/AIDS cases with central nervous system toxoplasmosis demonstrating five different neurological presentations. The ages, gender and clinical findings of the patients who were admitted to our Infectious Diseases Clinics were as follows; 35 years old male patient with delirium, 49 years old male patient with focal dystony, 32 years old female patient with facial paralysis and monoparalysis, 53 years old male patient with Wernicke syndrome, 32 years old male patient with epilepsy. Cerebral toxoplasmosis were diagnosed by clinical findings and imaging techniques. The patients were treated with trimetoprim-sulfametoxazol (TMP-SMZ) and haloperidol, only TMP-SMZ, clindamycin and daraprim, TMP-SMZ and levotiracetam, TMP-SMZ and phenytoin, respectively, with recovery in neurological and radiological symptoms. In conclusion, until proven otherwise, HIV/AIDS patients presenting with focal neurological complaints should be accepted as having central nervous system toxoplasmosis.
authors.affiliation: Hacettepe Universitesi Tip Fakültesi, Nöroloji Anabilim Dali, Ankara.
authors.forename: Asli
authors.initials: A
authors.lastname: Kurne
authors.forename: Gülşen
authors.initials: G
authors.lastname: Ozkaya
authors.forename: Kader
authors.initials: K
authors.lastname: Karlioğuz
authors.forename: Ali
authors.initials: A
authors.lastname: Shorbagi
authors.forename: Semsettin
authors.initials: S
authors.lastname: Ustaçelebi
authors.forename: Rana
authors.initials: R
authors.lastname: Karabudak
authors.forename: Serhat
authors.initials: S
authors.lastname: Unal
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D003693:Delirium / Q000469:parasitology; D020821:Dystonic Disorders / Q000469:parasitology; D004827:Epilepsy / Q000469:parasitology; D005158:Facial Paralysis / Q000469:parasitology; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016781:Toxoplasmosis, Cerebral / Q000188:drug therapy / Q000209:etiology* / Q000469:parasitology; D014899:Wernicke Encephalopathy / Q000469:parasitology