Prolonged isolated fever due to attenuated extracerebral toxoplasmosis in patients infected with human immunodeficiency virus who are receiving trimethoprim-sulfamethoxazole as prophylaxis.

Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Prolonged isolated fever due to attenuated extracerebral toxoplasmosis in patients infected with human immunodeficiency virus who are receiving trimethoprim-sulfamethoxazole as prophylaxis.

Clin Infect Dis. 1995 Sep;21(3):680-1. Unique Identifier : AIDSLINE MED/96077399
Zylberberg H; Robert F; Le Gal FA; Dupouy-Camet J; Zylberberg L; Viard JP; Service d'Immunologie Clinique, Hopital Necker, Paris, France.

Abstract: We report two cases of prolonged fever in deeply immunocompromised patients with AIDS who had been receiving trimethoprim-sulfamethoxazole (TMP-SMZ) as primary prophylaxis for several months. Investigations of the cause of fever yielded normal or negative findings except that the polymerase chain reaction (PCR) for Toxoplasma gondii in the blood was positive in both cases, and PCR of the bronchoalveolar lavage fluid was positive in one case. After a few days of treatment with pyrimethamine plus clindamycin, the two patients became afebrile and the T. gondii PCR became negative. The patients probably had disseminated toxoplasmosis attenuated by TMP-SMZ. PCR examination of blood for evidence of T. gondii genome may be useful in screening for causes of unexplained fever in patients with AIDS, even those who receive prophylaxis with TMP-SMZ.

Keywords: Adult Animal Antifungal Agents/PHARMACOLOGY Antiprotozoal Agents/*PHARMACOLOGY AIDS-Related Opportunistic Infections/*COMPLICATIONS/PREVENTION & CONTROL Case Report Fever/*ETIOLOGY Human *HIV-1 Male Middle Age Pneumonia, Pneumocystis carinii/COMPLICATIONS/PREVENTION & CONTROL Polymerase Chain Reaction Time Factors Toxoplasma/GENETICS/ISOLATION & PURIF Toxoplasmosis/*COMPLICATIONS/PREVENTION & CONTROL Trimethoprim-Sulfamethoxazole Combination/ADMINISTRATION & DOSAGE/ *PHARMACOLOGY JOURNAL ARTICLE
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M9640826

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