Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
NONVIRAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM IN PATIENTS WITH ACQUIRED IMMUNODEFICIENCY SYNDROME
AIDS and the Nervous System. Rosenblum ML et al, eds. New York, Raven Press, p. 263-83, 1988.. Unique Identifier : AIDSLINE ICDB/89648471 Pons VG; Jacobs RA; Hollander H; Dept. of Medicine, Div. of Infectious Diseases, Univ. of; California Sch. of Medicine, San Francisco, CA 94143
Abstract:
Infections of the CNS in patients (pts) with AIDS has emerged as one of the most profound problems ever to challenge the medical professions. It is estimated that 15-30% of AIDS pts with abnormal neurological signs or symptoms will have CNS toxoplasmosis, up to 12% will have cryptococcal meningitis, and another 5-10% will have other nonviral diseases of the CNS. The microbiology, clinical manifestations, diagnosis, and treatment of bacterial, mycobacterial, fungal, and parasitic infections of the CNS in pts with AIDS are described. Topics include toxoplasmosis, cryptococcosis, mycobacterial infections, candidiasis, aspergillosis, miscellaneous rare fungal infections, listeriosis, nocardiosis, and miscellaneous bacterial infections. The nonviral infections in AIDS can cause a wide variety of neurological and constitutional symptoms. The differential diagnosis is difficult because of the overlap in the clinical presentation of specific illnesses. The authors emphasize the importance of an aggressive diagnostic evaluation in these pts. Serological testing, cultures, cerebrospinal fluid analysis, and radiological imaging procedures may all provide valuable information, but each modality has significant shortcomings. Many of these nonviral infections respond well initially to conventional therapy, but relapse is a potential problem with virtually all AIDS-related infections, independent of organ system involvement. Emerging information suggests the utility of ongoing prophylactic therapy for cryptococcal meningitis and toxoplasmosis. It probably is necessary to continue such therapy for the rest of the pt's life. Current therapy for these diseases is limited by conventional toxicities and by those peculiar to the AIDS population. Thus, future research must concentrate on finding alternative, less toxic treatments. (82 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PATHOLOGY Brain/PATHOLOGY Brain Abscess/ETIOLOGY/PATHOLOGY Brain Diseases/ETIOLOGY/PATHOLOGY Cryptococcosis/ETIOLOGY/PATHOLOGY Human Meningitis, Listeria/ETIOLOGY/PATHOLOGY Mycoses/ETIOLOGY/PATHOLOGY Nocardia Infections/PATHOLOGY Opportunistic Infections/*ETIOLOGY/PATHOLOGY Toxoplasmosis/ETIOLOGY/PATHOLOGY Tuberculosis, Meningeal/ETIOLOGY/PATHOLOGY MONOGRAPH REVIEW, TUTORIAL REVIEW
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
