Problems related to the management of cerebral toxoplasmosis in AIDS patients in Africa.

Based on a retrospective study of 54 cases of cerebral toxoplasmosis, the a uthors report diagnostic, therapeutic and prognostic problems that occur in the management of this affection in a tropical African setting. The averag e age of the patients was 39 years, average latency of hospitalization was 23 days. Reasons for hospitalization were infectious syndrome (85%), high i ntracerebral pressure syndrome (55%) and focal neurologic syndrome (50%). C T scan was performed in only 72% of the subjects which showed most of the t ime multiple abcesses, The rate of relapse was 25%. Lost to follow-up after hospitalization represented 62%. Global mortality rate in hospitalization was 41%. Existence of encephalopathy and specific treatment other than sulf adiazine + pyrimethamin were the pejorative prognostic factors in neurotoxo plasmosis. The authors insist on education and follow-up of patients and se tting up of a chemoprophylaxis plan based on utilization of cotrimoxazole. (C) 1999 Elsevier, Paris.