Happe S, Fischer A, Heese Ch, Reichelt D, Grüneberg U, Freund M, Kloska S, Evers St, Husstedt I-W
Abteilung Klinische Neurophysiologie,Georg-August-Universität Göttingen.
Nervenarzt. 2002 Dec;73(12):1174-8. doi: 10.1007/s00115-002-1416-y.
Highly active antiretroviral therapy (HAART) has resulted in a reduction of morbidity and mortality in HIV-associated cerebral opportunistic infection. Before HAART, up to 50% of all HIV-infected patients in Europe developed cerebral toxoplasmosis, an encephalitis caused by reactivation of Toxoplasma gondii infection. Although potent therapeutical options exist, the prognosis is still poor. We describe the course of 36 AIDS patients with cerebral toxoplasmosis and present a review of clinical signs, diagnosis, therapy, and survival times. The main criteria for differential diagnosis from other secondary neuromanifestations such as primary CNS lymphoma, progressive multifocal leukencephalopathy, abscesses, and ischemic infarctions are described. Indications and problems of stereotactic biopsy are discussed.
高效抗逆转录病毒疗法（HAART）已使HIV相关脑机会性感染的发病率和死亡率有所降低。在HAART出现之前，欧洲高达50%的HIV感染患者会发生脑弓形虫病，这是一种由弓形虫感染重新激活引起的脑炎。尽管存在有效的治疗选择，但预后仍然很差。我们描述了36例脑弓形虫病艾滋病患者的病程，并对临床症状、诊断、治疗及生存时间进行了综述。还描述了与其他继发性神经表现如原发性中枢神经系统淋巴瘤、进行性多灶性白质脑病、脓肿和缺血性梗死进行鉴别诊断的主要标准。讨论了立体定向活检的适应证和问题。
