Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis
Autor(a) principal: | |
---|---|
Data de Publicação: | 2000 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/30425 |
Resumo: | We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm³ and blood lymphocytes lower than 350/mm³. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems. |
id |
IMT-1_f2e3147d6c05694b47780a31e4f404e6 |
---|---|
oai_identifier_str |
oai:revistas.usp.br:article/30425 |
network_acronym_str |
IMT-1 |
network_name_str |
Revista do Instituto de Medicina Tropical de São Paulo |
repository_id_str |
|
spelling |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis Encefalite por Toxoplasma em pacientes com AIDS em São Paulo, Brasil, durante 1988 e 1991. Análise retrospectiva comparativa Toxoplasma encephaliAClinical pictPrognoDeath rToxoplasma gonCentral Nervous Sys We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm³ and blood lymphocytes lower than 350/mm³. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems. Uma análise retrospectiva foi conduzida em pacientes com encefalite por Toxoplasma do Instituto de Infectologia Emílio Ribas, o principal hospital de AIDS em São Paulo, Brasil, durante dois períodos distintos, em diferentes níveis da epidemia de HIV. Existem diferenças demográficas relativas aos períodos, sendo a apresentação clínica e eficiência diagnóstica similar nos dois períodos. O diagnóstico era confirmado por dados tomográficos e resposta à terapia, com clara distinção de outras infecções do SNC, baseadas em dados clínicos e laboratoriais. Estudos sorológicos específicos foram menos executados em 1991, com maior freqüência de mudanças na terapia. A mortalidade aguda direta por toxoplasmose foi alta em ambos os períodos, 8/38 em 1988 e 10/33 em 1991. A taxa de mortalidade aguda conjunta nos dois períodos foi de 25,4% (18/71), relacionando-se ao tempo de infecção pelo HIV, ausência de febre, presença de sinais de irritação meníngea na apresentação, leucocitose acima de 10000/mm3 e número de linfócitos circulantes inferior a 350/mm3. A encefalite por Toxoplasma é uma doença com profilaxia e tratamento simples em pacientes com diagnóstico prévio de infecção pelo HIV. Infelizmente, esta doença grave e letal é a doença diagnóstica da infecção pelo HIV em muitos pacientes, e nossos dados reforçam que deve ser manuseada clinicamente com cuidado, especialmente naqueles países com maior prevalência de toxoplasmose onde a AIDS está associada a problemas econômicos e de Saúde Pública. Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2000-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/30425Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 No. 3 (2000); 141-145 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 Núm. 3 (2000); 141-145 Revista do Instituto de Medicina Tropical de São Paulo; v. 42 n. 3 (2000); 141-145 1678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/30425/32309Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Pauloinfo:eu-repo/semantics/openAccessPASSOS, Luciana NevesARAÚJO FILHO, Orlando Florentino deANDRADE JUNIOR, Heitor Franco de2012-07-07T09:34:35Zoai:revistas.usp.br:article/30425Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:51:11.779750Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis Encefalite por Toxoplasma em pacientes com AIDS em São Paulo, Brasil, durante 1988 e 1991. Análise retrospectiva comparativa |
title |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis |
spellingShingle |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis PASSOS, Luciana Neves Toxoplasma encephali A Clinical pict Progno Death r Toxoplasma gon Central Nervous Sys |
title_short |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis |
title_full |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis |
title_fullStr |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis |
title_full_unstemmed |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis |
title_sort |
Toxoplasma encephalitis in AIDS patients in São Paulo during 1988 and 1991. A comparative retrospective analysis |
author |
PASSOS, Luciana Neves |
author_facet |
PASSOS, Luciana Neves ARAÚJO FILHO, Orlando Florentino de ANDRADE JUNIOR, Heitor Franco de |
author_role |
author |
author2 |
ARAÚJO FILHO, Orlando Florentino de ANDRADE JUNIOR, Heitor Franco de |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
PASSOS, Luciana Neves ARAÚJO FILHO, Orlando Florentino de ANDRADE JUNIOR, Heitor Franco de |
dc.subject.por.fl_str_mv |
Toxoplasma encephali A Clinical pict Progno Death r Toxoplasma gon Central Nervous Sys |
topic |
Toxoplasma encephali A Clinical pict Progno Death r Toxoplasma gon Central Nervous Sys |
description |
We conducted a retrospective analysis of Toxoplasma encephalitis patients from Instituto de Infectologia Emílio Ribas, the main AIDS hospital of São Paulo, Brazil, during two different stages of the HIV epidemics, in 1988 (38 patients) and 1991 (33 patients). There were AIDS-related demographic differences, but the clinical presentation and diagnostic efficiency were similar, usually based on tomography and clinical response to therapy, with a clear distinction from other CNS infections, based on clinical and laboratory findings. Specific serologic studies were performed less often in 1991, with a high frequency of therapy change. The direct acute death rate from Toxoplasma encephalitis was high during both periods, i.e. 8/38 in 1988 and 10/33 in 1991. The direct acute death rate for the patients from the two periods as a whole was 25.4% (18/71), related to the time of HIV infection, absence of fever and presence of meningeal irritation at presentation, blood leukocytes higher than 10,000/mm³ and blood lymphocytes lower than 350/mm³. Toxoplasma encephalitis is a preventable disease when adequate prophylactic therapy is used and is relatively easy to treat in diagnosed HIV patients. Unfortunately, this severe and deadly disorder is the HIV diagnostic disease in several patients, and our data support the need for careful management of these patients, especially in those countries with a high toxoplasmosis prevalence where AIDS is concurrent with economic and public health problems. |
publishDate |
2000 |
dc.date.none.fl_str_mv |
2000-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30425 |
url |
https://www.revistas.usp.br/rimtsp/article/view/30425 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/30425/32309 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2018 Revista do Instituto de Medicina Tropical de São Paulo |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 No. 3 (2000); 141-145 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 42 Núm. 3 (2000); 141-145 Revista do Instituto de Medicina Tropical de São Paulo; v. 42 n. 3 (2000); 141-145 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
_version_ |
1798951642374078464 |