Assessment of therapy for toxoplasma encephalitis. The TE Study Group

Toxoplasma encephalitis has been reported as a life-threatening opportunistic infection among patients with the acquired immune deficiency syndrome. The TE Study Group was established to address clinical questions about Toxoplasma encephalitis by retrospectively reviewing available data. The medical centers selected were those reporting Toxoplasma encephalitis to the Centers for Disease Control or to one of the principal investigators. Sixty-eight histologically confirmed cases of Toxoplasma encephalitis were reported by investigators at 31 medical centers; 61 of the patients received some therapy. Overall prognosis was poor. The median survival following initiation of therapy was four months. Patients described as "alert" at initiation of therapy survived significantly longer than those described as "lethargic" or "stuporous." No beneficial or harmful effects could be attributed to the use of corticosteroids. Toxicity attributed to pyrimethamine and sulfonamide therapy was reported in 60 percent of patients. Leukopenia, rash, and thrombocytopenia were common during therapy. A clinical relapse of Toxoplasma encephalitis was reported in 50 percent of patients discharged from the hospital.