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Central-Nervous-System Toxoplasmosis in Homosexual Men and Parenteral Drug Abusers

BRIAN WONG, M.D.; JONATHAN W. M. GOLD, M.D.; ARTHUR E. BROWN, M.D.; MICHAEL LANGE, M.D.; RICHARD FRIED, M.D.; MICHAEL GRIECO, M.D.; DONNA MILDVAN, M.D.; JOSÉ GIRON, M.D.; MICHAEL L. TAPPER, M.D.; CHESTER W. LERNER, M.D.; and DONALD ARMSTRONG, M.D.
[+] Article and Author Information

Grant support: by the American Cancer Society Junior Faculty Clinical Fellowships 695A and 555A.

Presented in part on 9 October 1982 at the meeting of the Eastern Section of the American Federation of Clinical Research; Boston, Massachusetts.

▸Requests for reprints should be addressed to Brian Wong, M.D.; Infectious Diseases Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue; New York, NY 10021.


New York, New York


Ann Intern Med. 1984;100(1):36-42. doi:10.7326/0003-4819-100-1-36
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Central-nervous-system toxoplasmosis developed in 7 of 269 patients with the acquired immunodeficiency syndrome reported to the New York City Health Department through July 1982. Focal neurologic abnormalities, mass lesions on computed-tomographic brain scans, lymphocytic cerebrospinal fluid pleocytosis, and detectable IgG antibody to Toxoplasma gondii were common; but IgG titers of 1:1024 or more, IgM antibody to T. gondii, and positive open brain biopsies were uncommon. Serologic findings suggested that the disease resulted from recrudescent rather than primary infection. Four of five patients improved when treated with sulfonamides and pyrimethamine, but 2 had relapses. An aggressive diagnostic approach and sometimes even empiric therapy are warranted when central-nervous-system toxoplasmosis is suspected in a seropositive patient with the acquired immunodeficiency syndrome.

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