Toxoplasmosis: The Daily PANCE Blueprint

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Toxoplasmosis: The Daily PANCE Blueprint

A 52-year-old male with poorly controlled HIV (last CD4 count < 100 cells/uL) presents to the hospital with worsening fever, altered mentation, focal neurological deficits, and headaches. CT head reveals multiple ring-enhancing lesions. Which of the following is the best treatment option for this patient?

A. Pyrimethamine, sulfadiazine, and leucovorin
B. IV amphotericin B plus flucytosine
C. Prednisone and itraconazole
D. IV caspofungin and ampicillin
E. None of the above

Answer and topic summary

The answer is A. Pyrimethamine, sulfadiazine, and leucovorin

Toxoplasmosis is an infectious disease caused by a parasite, Toxoplasma gondii. It is transmitted from mother to fetus through the placenta or can occur due to the ingestion of cysts found in raw meat or cat feces. Most people who are not immunocompromised remain asymptomatic. Those who are immunocompromised may end up with toxoplasmosis in their brain or eyes. In fact, cerebral toxoplasmosis is the most common AIDS-defining illness of the nervous system. Treatment is a combination of pyrimethamine, sulfadiazine, and leucovorin.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ Parasitic Disease ⇒ Toxoplasmosis

Also covered as part of the Internal Medicine EOR topic list

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