Evidence-based practice: Management of Combined Toxoplasma meningo-encephalitis and Pneumocystis pneumonia in HIV

Bruck, Peter; Das, Sukta; Allan, P S

doi:10.4161/viru.1.4.11833

Cited by 3 publications

(2 citation statements)

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“…Although a drastic decrease has been observed both for non-CNS disease and CNS infections, P. jirovecii and T. gondii remain common opportunistic infectious agents. However, to our knowledge, reports of patients presenting with combined pulmonary and/or cerebral toxoplasmosis and pneumocystis infection are scarce [ 11 , 12 ]. Pulmonary toxoplasmosis (PT) has become a very rare parasitic infection since the advent of highly active antiretroviral therapies.…”

Section: Discussionmentioning

confidence: 99%

“…However, no case series have shown the efficacy of TMP-SMX alone for treating P. jirovecii and T. gondii co-infection. Bruck et al [ 12 ] summarized the recommendations for the management of combined PCP and TE based on 4 case reports of patients treated by (i) TMP-SMX + pyrimethamine + sulfadiazine, (ii) atovaquone + pyrimethamine + sulfadiazine, (iii) TMP-SMX + pyrimethamine + clindamycin, and (iv) pyrimethamine + clindamycin + primaquine. Clearly, the treatment choice should aim for the lowest toxicity.…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Pulmonary and Cerebral Toxoplasmosis Associated with Pneumocystis Pneumonia in an HIV Patient

et al. 2017

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In both the post and pre combination antiretroviral therapy (cART) era, Pneumocystis jirovecii and Toxoplasma gondii remain common opportunistic infectious agents. The common manifestations are pneumonia for P. jirovecii and brain abscess for T. gondii. Nevertheless, co-infection remains rare, and pulmonary toxoplasmosis is scarce, or may be underestimated because of its similarity with Pneumocystis jirovecii pneumonia. We reported an uncommon case of an AIDS patient (6 CD4 + T cells/mm3) with both pulmonary and cerebral toxoplasmosis associated with pneumocystis pneumonia. The patient presented with general weakness, fever and dyspnea. Pulmonary toxoplasmosis and pneumocystis were confirmed by microscopic examination and DNA detection in the bronchoalveolar lavage. Computed tomography imaging of the brain revealed a single characteristic cerebral toxoplasmosis lesion of the left capsular area. He was successful treated by trimethoprim/sulfamethoxaxole in conjunction with an early reintroduction of cART, and without IRIS development. During a 3-year follow-up, HIV viral load remained undetectable, and the patient did not relapse for toxoplasmosis or Pneumocystis pneumonia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%