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Ask the Experts about Opportunistic Infections

 

Is the seriousness of infection indicative of HIV/AIDS?
Jan 3, 2002

A dear friend was just hospitalized after his neighbor was not able to wake him one morning. He was rushed to emergency where doctors thought he had suffered a stroke. Since that first diagnosis, things have changed a bit and now I am very confused about his condition and whether he will survive. He has not been responsive for five days and the doctors have mentioned Lymphoma and Toxoplasmosis, but have not said which is the culprit of the lesions found in the brain, and why his brain had swollen to such a degree. I feel as though he might not pull through this. Does the severity of the situation point to a compromised immune system? It seems so serious and so sudden to everyone and we just wish we had more answers. As far as I know, no biopsy has been performed to determine whether it is hodgekins or non-hodgkins lymphoma. At this point I have to wonder if that even matters as his condition at present is so serious.

Response from Dr. Feinberg

Your friend's situation is indeed precarious. Since his doctors are considering toxoplasmosis or lymphoma, these causes of a brain damage are indicative of a damaged immune system. The reason the docotrs can't distinguish between these 2 diagnoses is that they can look very similar on brain scans. The only way to know for sure is to do a brain biopsy, and he might not survive that. In these situations, the patient is treated for toxoplasmosis, and the response (or non-response) helps guide other decisions. I hope that your friend improves, but the situation sounds extremely serious.



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