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Encefalic Toxoplasmosis Infection
Apr 5, 1999

My partner is HIV infected with viral charge in 220.000 and CD4 in 85. He had fever for 13 day before the diagnosis of Encephalic Toxoplasmosis by RM. He had 1 week of Clindamycin IV and 3 weeks with oral treatment (all 900 mg/8 h and pyrimethamine 50 mg/day). He have no neurologycal symptons and he is gonna change to a supressive therapy now. Its enough 4 weeks to change therapy and will he recover completely. Please, i need help.... Thanks

Response from Dr. Hellerstein

Clindamycin (900 mh every 8 hours) and pyrimethamine are proven initial therapies for Toxoplasmosis. Clindamycin is usually used for people who are allergic to sulfa, when there is no sulfa allergy we use sulfadiazine instead of clindamycin. The timing of a change from the initial induction ( high dose) therapy to maintenance therapy depends to some degree to the improvement seen by CT and generally 4-6 weeks is needed of the higher doses. If your friend is started on potent combination antiretroviral therapy and he continues the Toxo therapy there is a good chance for improvement. The overall prognosis will depend on the ability to increase the T cells with antivirals. It is a good sign that there are no ongoing neurologic symptoms. I hope this helps, good-luck.

-JC


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