An 34 year old male HIV patient on c-A presents with seizures, unilateral facial nerve palsy. CT scan shows ring enhancement lesion. Best treatment is:
Causes of seizures in HIV positive Pt: - HIV related encephalopathy Cerebral toxoplasmosis Neurocysticercosis CNS lymphoma Cerebral Toxoplasmosis MRI of cerebral toxoplasmosis showing 2 ring enhancing lesions- "lighting up" with intravenous contrast Rx: sulfadiazine +pyrimethamine +Leucovorin Neurocysticercosis - Rx - Albendazole + Dexamethasone Toxoplasmosis Primary CNS Lymphoma Quantity Multiple Solitary Lab Markers T. gondii IgG antibody (nonspecific) Epstein -Barr Virus Size < 4 cm > 4 cm Location Basal Ganglia Periventricular Cerebral Edema +++ + Prognosis Favorable (w/Rx) Poor
Albendazole with dexamethasone
Amphotericin B
ATT with steroids
Sulphadiazine, pyrimethamine and Leucovorin
JIPMER 2017