IMPACT OF THE PRIMARY PROPHYLAXIS OF CERE BRAL TOXOPLASMOSIS

In France, where 70 % of adults are latently infected by toxoplasma, f rom 20 % to 40 % of patients with AIDS developed toxoplasmic encephali tis until recently. The prophylactic use of drugs which are active aga inst pneumocystis and toxoplasma has proven to be efficient. These dru gs are trimethoprim-sulfamethoxazole or dapsone-pyrimethamine. With th e extent of these primary prophylaxis, there is a decrease of risk of toxoplasma encephalitis; thus the rate of toxoplasma encephalitis amon g opportunistic infections has fallen off from 19 % of the patients in 1988 to 6 % in 1994, in the department of infectious diseases of the Pitie-Salpetriere hospital. However, toxoplasmic abcesses occurring de spite the prophylaxis are frequently slow growing lesions which can be come huge with a moderate mass effect, mimicking the pattern of primar y cerebral lymphoma. The rule of antitoxoplasmic trial treatement must be strictly followed, even under prophylaxis.