title: Cerebral toxoplasmosis in patients with acquired immune deficiency syndrome in the neurological emergency department of a tertiary hospital.
abstract: BACKGROUND
  Cerebral toxoplasmosis is the most common cause of space occupying brain lesion in patients with HIV/AIDS in Brazil. In the post-HAART era, it is responsible for high rates of morbidity and mortality worldwide.
  
  
  METHODS
  This study consists of a case series of 56 patients diagnosed with cerebral toxoplasmosis whose clinical features, brain imaging and cerebrospinal fluid aspects were analyzed.
  
  
  RESULTS
  Cerebral toxoplasmosis led to the diagnosis of infection by the human immunodeficiency virus (HIV) in 27 (48.2%) of the patients, while 29 (51.2%) others already knew to be HIV seropositive. However, at the time of diagnosis of cerebral toxoplasmosis, only 9 (16.6%) reported being under antiretroviral therapy and 5 (8.9%) were receiving primary prophylaxis for toxoplasmosis. Headache, strength deficit and fever were the most frequent signs and symptoms throughout the study. Fifty-three patients showed changes consistent with toxoplasmosis in CT or MRI. Thirty-four (60.7%) CSF samples were positive in the indirect haemagglutination test and for the reaction of Toxoplasma gondii IgG ELISA, while 31 (55.4%) were positive in the direct haemagglutination test. Fifty (89.3%) patients underwent first-line treatment for toxoplasmosis.
  
  
  CONCLUSIONS
  Cerebral toxoplasmosis is still a very relevant neurological disease in individuals with AIDS admitted to neurology emergency departments. Early diagnosis and initiation of empiric treatment and antiretroviral therapy are important for good prognosis.
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: gabibrito_@hotmail.com.
authors: Gabriela Brito
authors: GB
authors: de Oliveira
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: almerice@cpqam.fiocruz.br.
authors: Maria Almerice Lopes
authors: MA
authors: da Silva
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: leandrowanderley@gmail.com.
authors: Leandro Batista
authors: LB
authors: Wanderley
authors: Department of Neurology, Faculdade de Ciências Médicas, Universidade de PernammbucoRua Arnóbio Marques, 310 - Santo Amaro, Recife/PE CEP: 50100-130, Brazil. Electronic address: carolina.dra@gmail.com.
authors: Carolina
authors: C
authors: da Cunha Correia
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: brandaoec@gmail.com.
authors: Eduardo Caetano Brandão
authors: EC
authors: Ferreira
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: medeiros@cpqam.fiocruz.br.
authors: Zulma Maria
authors: ZM
authors: de Medeiros
authors: Laboratório de Imunopatologia Keizo Asami, Av. Prof. Moraes Rego, 1235-Cidade Universitária, Recife, PE, CEP: 50670-901, Brazil. Electronic address: joseluiz60@gmail.com.
authors: José Luiz Lima
authors: JL
authors: Filho
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: fabio@cpqam.fiocruz.br.
authors: Fábio Lopes
authors: FL
authors: de Melo
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: psergiora@gmail.com.
authors: Paulo Sérgio Ramos
authors: PS
authors: de Araújo
authors: Laboratório de Doenças Transmissíveis, Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Av. Prof. Moraes Rego, s/n, Recife, PE, 50670 420, Brazil. Electronic address: alfredohcms@hotmail.com.
authors: Alfredo Henrique Cecílio Marins
authors: AH
authors: Santos
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000175:diagnosis / Q000453:epidemiology; D000328:Adult; D015897:Comorbidity; D004636:Emergency Service, Hospital; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology; D006679:HIV Seropositivity / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D062606:Tertiary Care Centers; D016781:Toxoplasmosis, Cerebral / Q000175:diagnosis* / Q000453:epidemiology; D055815:Young Adult
keywords: Acquired immunodeficiency syndrome; Cerebral toxoplasmosis; HIV