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August 17, 1984

Toxoplasmic Encephalitis in Patients With Acquired Immune Deficiency Syndrome

Author Affiliations

From the Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation (Drs Luft, Brooks, McCabe, and Remington), the Section of Neurosurgery, Veterans Administration Medical Center (Dr Conley), Palo Alto, Calif; the Division of Infectious Diseases, Department of Medicine, Stanford University Medical Center (Drs Luft, Brooks, McCabe, and Remington), and the Department of Neurosurgery, Stanford School of Medicine (Dr Conley), Stanford, Calif.

JAMA. 1984;252(7):913-917. doi:10.1001/jama.1984.03350070031018

An epidemic of cases of toxoplasmic encephalitis is occurring in patients with acquired immune deficiency syndrome (AIDS). Serological or histopathologic studies were performed on 70 cases with AIDS and toxoplasmic encephalitis. In many cases conventional stains of brain-tissue specimens failed to disclose Toxoplasma organisms; all were positive when stained by the peroxidase-antiperoxidase technique. Except for a single patient, serological titers were not indicative of an acute acquired infection. The ratio of titers in the agglutination test to titers in the Sabin-Feldman dye test seemed to be more predictive of active toxoplasmic encephalitis in patients with AIDS than either test alone. Based on histological and serological data, an approach is presented for diagnosis and treatment of suspected toxoplasmic encephalitis in patients with AIDS.

(JAMA 1984;252:913-917)