Toxoplasmosis Encephalitis

Clinical Info HIV

• Overview of management of TE as an opportunistic infection including diagnosis, expected presentation and treatment recommendations

1. What is the most common site of toxoplasma gondii reactivation? 

a) CNS

b) Skeletal muscle

c) Lungs 

d) Eyes

2. The following are risk factors for developing Toxoplasmosis Encephalitis (TE) in HIV patients EXCEPT?  

a) Not being on ART 

b) CD4<100 cells/ mm³

c) Changing cat litter 

d) All the above are risk factors for developing TE 

3. What is the most common CT/MRI finding in patients with TE? 

a) Lesions in the white matter of the brainstem

b) Lesions in the grey matter of the cortex or basal ganglia

c) Diffuse cerebral atrophy

d) Periventricular hemorrhage

4. Which of the following agents is recommended for TE primary prophylaxis?

a) Leucovorin

b) Sulfadiazine

c) Pyrimethamine

d) SMX/TMP

5. Your patient is initiating leucovorin + sulfadiazine + pyrimethamine for TE. What is the recommended duration of therapy?

a) 2 weeks of induction therapy then continue maintenance regimen to for an additional 4 weeks 

b) 4 weeks of induction therapy then continue maintenance regimen to for an additional 2 weeks 

c) 6 weeks of induction therapy then continue maintenance regimen until discontinuation criteria met  

d) 4 weeks of induction therapy then continue maintenance regimen until discontinuation criteria met