Abstract

CACEDA SANCHEZ, Ricardo et al. Cerebral toxoplasmosis in patients with AIDS at the Hospital Nacional Cayetano Heredia between 1989 and 1999. Rev Med Hered [online]. 2000, vol.11, n.1, pp.15-21. ISSN 1018-130X.

Objectives: To determine the clinical features of patients with toxoplasmic encephalitis and AIDS. To find out factors related to outcome. Material and methods: We conducted a retrospective study with adult patients admitted to Hospital Nacional Cayetano Heredia with AIDS and toxoplasmic encephalitis between 1989 and 1999. Results: We report 65 cases (6.7% of the hospital adult AIDS population). The most frequent clinical findings were focal neurological deficits (80%), sensorium alteration, cephalalgia, and fever in more than 50%. The clinical diagnosis was confirmed with positive serology in 75% of cases. In fifty patients CT scan was performed, the main findings were hypodense, ring enhancing lesions with peripheral edema and hydrocephalia. Fifty-four (83.1%) of patients received clindamycin and pyrimetamine in the standard doses, 10 of them developed mild adverse reactions, mainly hematological. Thirty-five (53.8%) had a favorable outcome, 51.2% remained with sequelae, hemiparesia was the most common. We observed a mortality rate of 43.2%, mainly occurring in the first 15 days of diagnosis. Presumptive diagnosis based in clinical, serologic and CT findings was associated with a better outcome (OR=4.21, 95% IC 1.17-17.03), whereas a negative association with coma was found (OR=0.19, 95% IC 0.05-0.63). Conclusions: The clinical findings of toxoplasmic encephalitis in this study are similar to those reported in the literature. Presumptive diagnosis was associated to better outcome. ( Rev Med Hered 2000; 11: 15-21 ).

Keywords : AIDS-toxoplasmic encephalitis; clinical criteria.

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