Document 0030
 DOCN  M9590030
 TI    Disseminated toxoplasmosis in AIDS patients--report of 16 cases.
 DT    9509
 AU    Albrecht H; Skorde J; Arasteh K; Heise W; Stellbrink HJ; Grosse G; L'Age
       M; Department of Internal Medicine, University Clinic Eppendorf,;
       Hamburg, Germany.
 SO    Scand J Infect Dis. 1995;27(1):71-4. Unique Identifier : AIDSLINE
       MED/95304293
 AB    Between June 1986 and October 1992, disseminated toxoplasmosis was
       diagnosed in 16 AIDS patients. 13 cases were diagnosed at autopsy where
       multiple organ involvement was documented in all 13. Three patients were
       diagnosed intra vitam. All 3 survived with appropriate treatment.
       Clinical features indicative of disseminated toxoplasmosis were: fever
       of unknown origin between 39 degrees and 40 degrees C in 16 cases,
       clinical signs suggestive of sepsis or septic shock in 15, with
       progression to multiorgan failure in 10, disseminated intravascular
       coagulopathy in 6, confusion, disorientation or apathy in 13 and lack of
       a systemic pneumocystis carinii prophylaxis in all 16. Typical
       laboratory markers were: CD4 cell counts below 100 x 10(6)/l in 16
       cases, elevation of serum lactic dehydrogenase in 16 and creatine
       phosphokinase (in 4/6), normal or only slightly elevated C-reactive
       protein (in 9/11), positive Toxoplasma gondii IgG antibodies in 15/16
       and negative IgM antibodies in all 16. Lesions indicative of cerebral
       toxoplasmosis were visualized on cranial computerized tomography in only
       3/10 evaluated patients. In patients with advanced HIV infection
       presenting with a systemic illness, including the clinical and
       laboratory features described above, systemic Toxoplasma gondii
       infection must be included in the differential diagnosis. In these
       patients, specific and if warranted, invasive diagnostic procedures
       followed by early vigorous therapeutic intervention should be
       considered.
 DE    Animal  Antibodies, Protozoan/BLOOD  Autopsy  AIDS-Related Opportunistic
       Infections/*DIAGNOSIS/EPIDEMIOLOGY  Brain/PARASITOLOGY  Case Report  CD4
       Lymphocyte Count  Diagnosis, Differential  Disseminated Intravascular
       Coagulation/PARASITOLOGY  Fatal Outcome  Human  IgG/BLOOD
       Sepsis/ETIOLOGY  Toxoplasmosis/COMPLICATIONS/*DIAGNOSIS/IMMUNOLOGY
       Toxoplasmosis, Cerebral/DIAGNOSIS/PARASITOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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