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Cerebral toxoplasmosis Category: disease

= encephalitis of toxoplasma gondii, e.g. from raw meat and cat deposits
sympt: focal neurology, diffuse encephalopathy, seizures, 50% has fever and/or headache
CT/MRI: multiple space occupying lesions with edema, ring-shaped enhancement
(in case of solitary haard on CT a lymphoma is more likely -> make MRI)
LP: not indicated
ther: also seronegative patients with negative CT findings: lifelong therapy!
Sulfadiazine 1000 mg 4 dd po (50% dose reduction after 6-8 weeks) + Pyrimethamine 15 mg 1 dd po + Foline 15 mg 1dd po. Often allergic reaction to sulfa. Alternative: Clindamycine 1000 mg 2 dd po (or iv, e.g. in case of diarrhoea)
course: improvement within 2 wk; recurrence chance of 10%

Last modified: 2008-05-13 Level: physician Article visits: 3630
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