Carrazana E J, Rossitch E, Samuels M A
Division of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Clin Neurol Neurosurg. 1989;91(4):291-301. doi: 10.1016/0303-8467(89)90004-8.
We examined the clinical and pathological features of 26 patients who presented with a diagnosis of CNS toxoplasmosis. Patient data was analyzed with respect to demographics, clinical presentation, treatment course and pathology. Patients presented with a wide variety of signs and symptoms. All patients had positive serum antitoxoplasma IgG; ring enhancing lesion(s) were present on all but one brain CT scans. A series of guidelines in the management of CNS toxoplasmosis in AIDS patients are presented. Prior to biopsy, patients with positive serology and characteristic CT scans should receive two weeks of treatment. Biopsy is indicated in those cases with negative serology, atypical presentation, progressive clinical deterioration, or differential response of lesions to empiric therapy.
我们研究了26例被诊断为中枢神经系统弓形虫病患者的临床和病理特征。分析了患者关于人口统计学、临床表现、治疗过程和病理学的数据。患者表现出各种各样的体征和症状。所有患者血清抗弓形虫IgG均为阳性；除1例脑部CT扫描外，其余所有扫描均显示有环形强化病变。本文提出了一系列艾滋病患者中枢神经系统弓形虫病的管理指南。在活检前，血清学阳性且CT扫描具有特征性的患者应接受两周的治疗。对于血清学阴性、表现不典型、临床进行性恶化或病变对经验性治疗反应不同的病例，应进行活检。
