Factores que influyen en el pronóstico de toxoplasmosis cerebral asociada a vih/sida
Fecha
2023
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
Introducción: La Toxoplasmosis cerebral es la principal enfermedad
oportunista del sistema nervioso central en pacientes que viven con VIH. Se
estima una seroprevalencia del 44.22% según un metaanálisis realizado por
Safarpour et al. y hasta 1/3 de estos pacientes evoluciona a una encefalitis
toxoplásmica, en especial aquellos con un conteo de linfocitos T CD4 <50
células. Objetivo: Identificar cuáles son los factores que influyen en el pronóstico
de pacientes con toxoplasmosis cerebral asociad a VIH/SIDA en el hospital “Dr.
José Daniel Rodríguez Maridueña”. Metodología: Se trato de un estudio
retrospectivo de tipo descriptivo ya que se describe la forma de presentación
clínica de esta patología del año 2019 al 2021 en el Hospital de infectología “Dr.
José Daniel Rodríguez Maridueña. Resultados: Se observo 47 casos de
toxoplasmosis cerebral. Los signos clínicos fueron principalmente fiebre en 47
(100%), cambios psicomotores o conductuales en 34(72.3%), cefalea en
33(70.2%), focalidad neurológica 25(53.2%), alteración de la consciencia
24(51,1%), convulsiones 16(34.0%) y trastornos visuales 10(21.3%). Un
recuento de CD4 < 100 fue un factor asociado con mortalidad. Conclusiones:
La toxoplasmosis cerebral es una infección oportunista que puede afectar
gravemente a pacientes con VIH. el estado inmunológico al ingreso,
específicamente el nivel de células CD4, está directamente asociado con la
mortalidad mientras que la presentación clínica no mostró un efecto sobre el
pronóstico. El 55.3% de los pacientes fallecieron y el 14.9% presentaron alguna
discapacidad al momento del alta
Introduction: Cerebral toxoplasmosis is the main opportunistic disease of the central nervous system in patients living with HIV. A seroprevalence of 44.22% is estimated according to a meta-analysis conducted by Safarpour et al., and up to 1/3 of these patients develop toxoplasmic encephalitis, especially those with a CD4 T cell count <50 cells. Objective: To identify the factors that influence the prognosis of patients with HIV/AIDS-associated cerebral toxoplasmosis at the "Dr. José Daniel Rodríguez Maridueña" hospital. Methodology: This was a retrospective descriptive study, as it describes the clinical presentation of this pathology from 2019 to 2021 at the "Dr. José Daniel Rodríguez Maridueña" Infectious Diseases Hospital. Results: 47 cases of cerebral toxoplasmosis were observed. The clinical signs were mainly fever in 47 (100%), psychomotor or behavioral changes in 34 (72.3%), headache in 33 (70.2%), neurological focalization in 25 (53.2%), alteration of consciousness in 24 (51.1%), seizures in 16 (34.0%), and visual disturbances in 10 (21.3%). A CD4 count <100 was a factor associated with mortality. Conclusions: Cerebral toxoplasmosis is an opportunistic infection that can severely affect patients with HIV. The immunological status at admission, specifically the CD4 cell level, is directly associated with mortality, while the clinical presentation did not show an effect on prognosis. 55.3% of patients died and 14.9% presented some disability at discharge.
Introduction: Cerebral toxoplasmosis is the main opportunistic disease of the central nervous system in patients living with HIV. A seroprevalence of 44.22% is estimated according to a meta-analysis conducted by Safarpour et al., and up to 1/3 of these patients develop toxoplasmic encephalitis, especially those with a CD4 T cell count <50 cells. Objective: To identify the factors that influence the prognosis of patients with HIV/AIDS-associated cerebral toxoplasmosis at the "Dr. José Daniel Rodríguez Maridueña" hospital. Methodology: This was a retrospective descriptive study, as it describes the clinical presentation of this pathology from 2019 to 2021 at the "Dr. José Daniel Rodríguez Maridueña" Infectious Diseases Hospital. Results: 47 cases of cerebral toxoplasmosis were observed. The clinical signs were mainly fever in 47 (100%), psychomotor or behavioral changes in 34 (72.3%), headache in 33 (70.2%), neurological focalization in 25 (53.2%), alteration of consciousness in 24 (51.1%), seizures in 16 (34.0%), and visual disturbances in 10 (21.3%). A CD4 count <100 was a factor associated with mortality. Conclusions: Cerebral toxoplasmosis is an opportunistic infection that can severely affect patients with HIV. The immunological status at admission, specifically the CD4 cell level, is directly associated with mortality, while the clinical presentation did not show an effect on prognosis. 55.3% of patients died and 14.9% presented some disability at discharge.
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TOXOPLASMOSIS CEREBRAL, VIRUS DE INMUNODEFICIENCIA HUMANA, SINDROME DE INMUNODEFICIENCIA ADQUIRIDA, PRONOSTICO, EPIDEMIOLOGIA DESCRIPTIVA, ESTUDIOS RETROSPECTIVOS, HOSPITAL DE INFECTOLOGIA DR. JOSE DANIEL RODRIGUEZ MARIDUEÑA, CANTON GUAYAQUIL, ECUADOR