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We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed.Five were homosexual men and eight patients(5 men,3 women)were of African origin (Zaire and Rwanda)(n=5)or had had sexual intercourse with the local African population(n=3).The nervous system complications encountered included:toxoplasma gondii brain abscess(2 patients);cryptococcus neoformans meningitis+toxoplasmosis(1 patient);toxoplasmosis+lymphoma(2 patients);progressive multifocal leucoencephalopathy(1 patient); lymphocytic meningitis or encephalitis(3 patients);lymphoma(1 patient); polyradiculoneuritis(3 patients).Three of thirteen patients had multiple intracranial abnormalities:one had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis;in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess;conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma.In conclusion,in our experience,nervous system toxoplasmosis is the most frequent AIDS related CNS complication.Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately.In these cases,while CT may readily identify the intracranial abnormalities,it contributes little towards an etiological diagnosis.Finally,our series illustrates the importance of a central African endemic focus for AIDS. |
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acquired immunodeficiency syndrome
brain biopsy
CAT scan
CAT scan,abnormal
lymphoma
lymphoma involving CNS
MRI
MRI,abnormal
MRI,CAT scan compared to
toxoplasmosis,CNS
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