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failure in the treatment of neurotoxoplasmosis
Jan 7, 2000

What are the reasons for failure in the treatment for proven toxoplama encephalitis ( cerebral biopsy)in an AIDS patient?

Is it related to medications used (sulfadiazine+ pirimethamine X clindamycin + pirimethamine)?

Is it related to the degree of imunodeficiency?

How long does it take in order to relapse from neurotoxoplasmosis if the patient was non aderent to secondary prophilaxis?(minimum and average time)

Response from Dr. Feinberg

Some patients who don't respond to sulfa/pyrimethamine will respond to clindamycin/pyrimethamine. Alternative treatments also include atovaquone. Probably the most common reason for relapse is failure to tkae the medications. People with toxo usually have severe immune deficiency to begin with, so it's not related to that. I can't tell you exactly how long it would take to relapse-- that varies too much. Another way to get optimal control of toxo or any OI is to take combination medicines for HIV and improve the immune system.


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