title: Clinical presentation and outcome of toxoplasma encephalitis in HIV-infected patients from Zaria, Northern Nigeria: a case series of 9 patients.
abstract: Toxoplasma encephalitis (TE) is the most common cause of focal deficits in patients living with HIV/AIDS. Among 257 HIV-infected adult patients seen between January 2006 and December 2010 in a tertiary hospital in Zaria, northern Nigeria, 9 (3.5%) patients had clinical, serological, and brain imaging evidence of TE. All 9 patients had CD4 count of less than 50 cells/mm(3). Of the 9 patients, 7 were antiretroviral therapy (ART)-naive, while 2 were cases of ART-induced TE-immune reconstitution inflammatory syndrome. After administering intravenous dexamethasone for cerebral decompression and specific antitoxoplasma therapy, symptoms and signs resolved in 8 patients within 4 to 14 days, but 1 patient died. Our data suggest that even in the ART era in Nigeria, TE remains a fairly common cause of morbidity among HIV-infected patients due to late HIV diagnosis and significant immunosuppression at diagnosis. Early HIV diagnosis, early initiation of highly active ART, and routine prophylaxis against TE are imperative in combating the challenge of HIV/AIDS-related TE in Nigeria.
authors: Department of Medicine, College of Health Sciences, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa, Nigeria.
authors: Dimie
authors: D
authors: Ogoina
authors: Reginald O
authors: RO
authors: Obiako
authors: Geoffrey C
authors: GC
authors: Onyemelukwe
authors: Bolanle O
authors: BO
authors: Musa
authors: Ahmed Umdagas
authors: AU
authors: Hamidu
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D000293:Adolescent; D000328:Adult; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012640:Seizures / Q000382:microbiology / Q000821:virology; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology / Q000821:virology; D016896:Treatment Outcome
keywords: HIV/AIDS; IRIS; Nigeria; cerebral toxoplasmosis; focal seizures; toxoplasma encephalitis