Clinical and diagnostic findings in 20 patients with toxoplasmosis and the acquired immune deficiency syndrome.

The clinical and diagnostic findings in 20 cases of toxoplasmosis associated with the Acquired Immune Deficiency Syndrome (AIDS) were investigated in a prospective study of patients in south-east England. Individual details were recorded by a standardised questionnaire incorporating an evaluation of initial presentation, radiological findings, therapy and clinical progression. Toxoplasma serology was performed by reference assays and the presence of the parasite in tissue was sought by culture, histological examination and specific DNA detection. Clinical findings at presentation and results of radiological investigation were comparable with previously published experience from the USA. In contrast, sampling of the cerebrospinal fluid was rarely performed and was found to be of little clinical value. Examination of tissue samples was diagnostic when available, but was not performed routinely. Sulphonamide plus pyrimethamine was the treatment of choice in most cases and response to therapy was satisfactory, although a high incidence of toxicity was recorded.