MANEJO DE INFECÇÃO POR TOXOPLASMOSE NO SISTEMA NERVOSO CENTRAL DE PACIENTES HIV POSITIVO

Autores

  • Saulo Bueno De Azeredo
  • Gean Scherer da Silva
  • Gabriela Kohl Hammacher
  • Natália Gonçalves Rengel
  • Fabiana Tonial

DOI:

https://doi.org/10.51161/rems/689

Palavras-chave:

Manejo, Neuroinfecção, Toxoplasmose

Resumo

Introdução: A avaliação e manejo de pacientes HIV positivos com mudança de estado mental ou exame neurológico anormal é um desafio. É comum haver lesões em exames de imagem que dependendo do tamanho e localização são emergências médicas. O fator mais importante para determinar um diagnóstico dentre outros é a o grau de imunossupressão – contagens menores que 200 CD4/microL há grande chance de infecção oportunística ou tumores derivados da Síndrome da Imunodeficiência Adquirida (SIDA). Objetivo: Analisar como é o manejo de infecção por toxoplasmose no sistema nervoso central de pacientes HIV positivo. Material e métodos: Esse trabalho é uma revisão de literatura sobre o manejo da neuroinfecção por toxoplasmose em pacientes sidéticos. Pesquisou-se no SCIELO e PUBMED os descritores: “toxoplasmose, SIDA, manejo, tratamento, sistema nervoso central” suas combinações e variantes em inglês. Resultados: Há, segundo a literatura, formas diferentes de manejo a depender da contagem de células CD4. O ideal seria a correta investigação da condição que está levando o paciente a ter os sintomas conduzida pelos exames de imagem – tomografia computadorizada e ressonância nuclear magnética com dois tempos de contraste – feitos no início do cuidado médico, que devem evidenciar lesões nodulares com ou sem edema no parênquima cerebral. Após a identificação das lesões do parênquima cerebral, deveria ser feita punção liquórica para análise das características laboratoriais e PCR do líquor em busca do agente patológico gerador da moléstia, para posterior tratamento. Há, entretanto, outra metodologia terapêutica que visa o tratamento empírico para toxoplasmose logo após a identificação das lesões cerebrais devido à alta incidência de neuroinfecção no público sidético. Nessa modalidade, depois da visualização das lesões e início do tratamento, prossegue-se com a investigação diagnóstica. O tratamento é feito com sulfadiazina e pirimetamina por 10 a 14 dias. Conclusão: Tendo em vista o proposto, torna-se evidente que o fator mais importante para fazer diagnóstico e tratamento precoces – fundamentais para bons resultados – é saber a contagem de CD4, norteador de todo o esquema de manejo.

Revista Multidisciplinar em Saúde - V. 2, N. 1, 2021

Publicado

2021-03-01

Como Citar

De Azeredo, S. B., Silva, G. S. da, Hammacher, G. K., Rengel, . N. G., & Tonial, . F. (2021). MANEJO DE INFECÇÃO POR TOXOPLASMOSE NO SISTEMA NERVOSO CENTRAL DE PACIENTES HIV POSITIVO. Revista Multidisciplinar Em Saúde, 2(1), 9. https://doi.org/10.51161/rems/689

Edição

v. 2 n. 1 (2021): Edição Especial: Anais de Eventos

Seção

Anais do Congresso Brasileiro de Parasitologia Humana On-line

Licença

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

O conteúdo desta revista foi migrado para https://editoraintegrar.com.br

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