Cissoko Y, Seydi M, Fortes Deguenonvo L, Attinssounon A C, Diop Nyafouna S A, Manga N M, Dia Badiane N D M, Tidiane Ndour C, Soumare M, Diop B M, Sow P S
Service des maladies infectieuses Ibrahima-Diop-Mar, CHNU de Fann de Dakar, Avenue Cheikh-Anta-Diop, BP 5035, Dakar, Sénégal.
Med Sante Trop. 2013 May 1;23(2):197-201. doi: 10.1684/mst.2013.0179.
To describe the current epidemiologic, clinical, diagnostic, and prognostic characteristics of cerebral toxoplasmosis in a hospital setting in Dakar.
This descriptive and analytic study examined the records of all HIV-positive patients with cerebral toxoplasmosis hospitalized at the infectious disease department at Fann (teaching) Hospital from January 2007 through December 2010. The diagnosis was based on clinical and computed tomography criteria completed by a therapeutic test with Cotrimoxazole.
There were 26 cases of cerebral toxoplasmosis during the study period. The sex ratio (F/M) was 1.4. The mean age was 41.5 ± 11.2 years. The clinical signs were predominantly fever (88.5%), headache (77.5%), focal signs (64.5%), and disorders of consciousness (61.5%). Brain lesions were most often multiple (64.3%), with mass effects (54.1%) and peripheral edema (77.8%). Seven of the 26 patients died (lethality rate: 29.1%). Impaired consciousness (p = 0.023), high CD8 T-cell counts (p = 0.009), and anemia (p = 0.003) were significantly associated with a higher mortality rate.
Cerebral toxoplasmosis remains a complication of AIDS in Dakar. Anemia, impaired consciousness, and high CD8(+) T cell counts were factors indicative of poor prognosis.
