HIV-related toxoplasma encephalitis: a tertiary care experience

Kurniawan Adi Prabowo, Anak Agung Ayu Yuli Gayatri, Ni Made Dewi Dian Sukmawati, Made Susila Utama, Ketut Agus Somia, Ketut Tuti Parwati Merati
2021 Indonesia Journal of Biomedical Science  
Toxoplasma encephalitis (TE) is the most commonly found in HIV patients who have no cotrimoxazole prophylaxis, especially when the CD count is <100 / µL. Therapy is often based on a presumptive diagnosis because definitive diagnosis is difficult, and TE can be life threatening. Aim of this study is to provide a characteristic description of TE in HIV patients who admitted at Sanglah Hospital. Methods: This is a retrospective descriptive study of 43 adult patients admitted with diagnosis TE at
more » ... e Sanglah Hospital, Indonesia between January 1st 2018 to December 31th 2018. Results: Most patients were male (69.8%), with the predominant age ranged 31-40 years old (39.5%). Among all patients; 14% on cotrimoxazole prophylaxis, and 23.3% on antiretroviral therapy. The most common clinical manifestation was headache (58.1%). Oral candidiasis was found in 67.4% of patients. CD4 levels <100 cells / µL were found in 62.8% of patients, absolute lymphocytes <500 / µL in 32.6% of patients. Anemia was found in 37.2% of patients. Multiple ring enhancement was the most common feature found on head CT scan, with the profound location was parietal lobe (46.5%). Pyrimethamine + clindamycin is used in 72.1% of cases. The TE mortality rate in HIV patients in this study was 11.6%. Conclusion: TE in HIV patients was more common on male, younger age and who are not receiving appropriate prophylaxis and/or without antiretroviral therapy. Laboratory study predominantly showed severe immunodeficiency. The most patients making a full recovery with pyrimethamine and clindamycin treatment.
doi:10.15562/ijbs.v15i2.331 fatcat:uscrjiupozbxje3mtaqqwrqxoa