Chang C C, Liao S T, Kuo S Y, Chu S J, Chen C M, Shih T Y, Chang M L, Chang D M
Department of Internal Medicine, Taipei Municipal Jen-Ai Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1995 Jan;55(1):69-73.
Central nervous system (CNS) toxoplasmosis is an important infectious complication of acquired immunodeficiency syndrome (AIDS) which appears to result from reactivation of a previously acquired infection and requires prolonged treatment. A 31-year-old male presented in a drowsy mental state and with an unstable gait. Computerized tomographic (CT) scan and magnetic resonance imaging (MRI) showed multiple nodular lesions in the cerebrum and cerebellum; the seropositivity for the human immunodeficiency virus (HIV-1) and high serum IgG toxoplasma titers were also demonstrated. A presumptive diagnosis of CNS toxoplasmosis was based on neurological signs and neuroradiological findings. This was confirmed by improvement in both clinical and neuroradiological pictures during treatment with pyrimethamine and clindamycin. Four months later, however the patient died of intracranial hemorrhage and massive upper GI bleeding.
中枢神经系统（CNS）弓形虫病是获得性免疫缺陷综合征（AIDS）的一种重要感染性并发症，似乎是由先前获得的感染重新激活所致，需要长期治疗。一名31岁男性，呈嗜睡精神状态，步态不稳。计算机断层扫描（CT）和磁共振成像（MRI）显示大脑和小脑有多个结节性病变；还检测出人类免疫缺陷病毒（HIV-1）血清阳性以及血清弓形虫IgG滴度很高。基于神经体征和神经放射学检查结果，初步诊断为中枢神经系统弓形虫病。在用乙胺嘧啶和克林霉素治疗期间，临床和神经放射学表现均有改善，从而证实了该诊断。然而，四个月后，患者死于颅内出血和大量上消化道出血。
