A Case who Developed Toxoplasma Encephalitis as the Initial Manifestation of AIDS.

DOI
  • Uchiumi Hideki
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Isoda Jun
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Toda Hisako
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Shirota Atsuko
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Narahara Nobuhiro
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Tamura Jun'ichi
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Naruse Takuji
    The 3rd Department of Internal Medicine, Gunma University School of Medicine
  • Shimano Shun-ichi
    Department of Hematology, Gunma Cancer Center
  • Sano Takaaki
    Department of Pathology, Gunma University School of Medicine
  • Suzuki Mamoru
    Department of Parasitology, Gunma University School of Medicine

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Other Title
  • トキソプラズマ脳炎を初発症状として発症したＡＩＤＳの１例

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Abstract

A 31 year-old Brazilian male complained of paresthesia in the right hand and then developed right hemiplegia and left cranial nerve III paresis. Magnetic resonance imaging brain scanning revealed a 3 cm diameter mass lesion occupying the left midbrain to thalamus. Since the mass was indistinguishable from a primary CNS lymphoma, the patient underwent stereotactic brain biopsy and was diagnosed as toxoplasma encephalitis by an immunostaining technique. He was treated by 3 combined therapy with pyrimethamine, clindamicin and salfamonomethoxine. The mass was remarkably diminished in MRI and his leval of consciousness improved although his neurological symptoms had not changed. About 13 months later, he developed systemic convulsions and sudden apnea, suggesting brain herniation. He died even though treatment with pyrimethamine had been continued.

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