Heitman B B, Irizarry A F
Adult Day Health Care Program, Miami Veterans Administration Medical Center, USA.
Nurse Pract. 1997 Sep;22(9):75, 79-82, 85-6 passim.
Toxoplasma gondii is a frequent cause of subclinical latent human infection and an important opportunistic pathogen that may cause severe disease in immunocompromised patients. Patients with AIDS who have antibodies to T. gondii should be considered at high risk for development of clinical disease (toxoplasmosis). Reactivation of latent infection in the central nervous system is a common HIV/AIDS-related complication in these patients. Typical presenting symptoms are headache, confusion, fever, and focal neurologic deficits. Routine serologic tests cannot distinguish active from latent infection. Neuroradiologic studies may be highly suggestive of toxoplasmic encephalitis, but the definitive diagnosis can be made only by demonstration of toxoplasma in brain tissue. The unique pathogenesis of toxoplasmic encephalitis in patients with AIDS necessitates intensive primary therapy followed by life long suppressive therapy. Clinical and radiographic improvement is usually rapid with appropriate treatment.
弓形虫是人类亚临床潜伏感染的常见病因，也是一种重要的机会性病原体，可在免疫功能低下的患者中引起严重疾病。有弓形虫抗体的艾滋病患者应被视为发生临床疾病（弓形虫病）的高危人群。中枢神经系统潜伏感染的重新激活是这些患者中常见的与HIV/AIDS相关的并发症。典型的表现症状为头痛、意识模糊、发热和局灶性神经功能缺损。常规血清学检测无法区分活动性感染和潜伏性感染。神经放射学研究可能高度提示弓形虫性脑炎，但只有在脑组织中发现弓形虫才能做出明确诊断。艾滋病患者弓形虫性脑炎独特的发病机制需要强化的初始治疗，随后进行终身抑制治疗。经过适当治疗，临床和影像学改善通常很快。
