       Document 0477
 DOCN  M9640477
 TI    Prolonged isolated fever due to attenuated extracerebral toxoplasmosis
       in patients infected with human immunodeficiency virus who are receiving
       trimethoprim-sulfamethoxazole as prophylaxis.
 DT    9604
 AU    Zylberberg H; Robert F; Le Gal FA; Dupouy-Camet J; Zylberberg L; Viard
       JP; Service d'Immunologie Clinique, Hopital Necker, Paris, France.
 SO    Clin Infect Dis. 1995 Sep;21(3):680-1. Unique Identifier : AIDSLINE
       MED/96077399
 AB    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.
 DE    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

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

