[Cerebral toxoplasmosis during AIDS in the infectious diseases department of Point-G Teaching Hospital, Bamako, Mali].

Cerebral toxoplasmosis is common opportunistic infections of central nervous system in AIDS. It occurs most often in case of severe immunosuppression. The aim of this study is to investigate the general characteristics of cerebral toxoplasmosis during HIV infection and AIDS in hospital area in Bamako. It is a retrospective study of 5 years (form January 2001 to December 2005), conducted in the infectious diseases department of Point G Teaching Hospital of Bamako. It concerned all patients infected with HIV, hospitalized for cerebral toxoplasmosis. The diagnosis of cerebral toxoplasmosis was based on clinical, C T and therapeutic arguments. A total of 745 patients investigated, 26 met cerebral toxoplasmosis diagnostic criteria (14 men and 12 women). The rate of cerebral toxoplasmosis in the study population was 3.5%. The average age was 38.1 years (18-58 years). Focused neurological deficit (73.07%), intracranial hypertension signs (69.20%), meningeal syndrome (15.40%), seizures (57.69%) and consciousness disorders (30.80%) were the clinical characteristics. Hypodensity with or without peripheral enhancement images (93.75%) were found on CT. The average rate of CD4 T cells was 98.7cells/mm3 (5-473 cells/mm3). Oropharyngeal candidiasis in 61.53% of cases, intestinal cryptosporidiosis (11.53%), herpes zoster (3.84%) and Pott's disease (3.84%) were the opportunistic infections associated. Cotrimoxazole was used in 88.46% of patients and 3 patients (11.54%) received the standard treatment (Sulfadiazine-Pyrimethamine). Antitoxoplasmic treatment led to a clinical improvement in 84.61% and 4 deaths (15.39%). were recorded. The technical platform for etiological diagnosis of toxoplasmosis is not available at the Point-G Teaching Hospital, so in case of encephalitis signs in a HIV positive patient, CT should be urgently perform and a treatment trial must begin without delay.