Open AccessManagement of HIV-associated focal brain lesions in developing countries - experience at Chris Hani Baragwanath Hospital
Author(s) -
Mala Modi,
Andre Mochan,
Girish Modi
Publication year - 2005
Publication title -
sa journal of radiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.18
H-Index - 3
eISSN - 2078-6778
pISSN - 1027-202X
DOI - 10.4102/sajr.v9i2.83
Subject(s) - medicine , radiological weapon , human immunodeficiency virus (hiv) , radiology , subcutaneous port , general surgery , family medicine , stereotactic radiotherapy , radiosurgery , radiation therapy
BACKGROUNDHIV-associated focal brain lesions (HFBL) are caused by opportunistic infections, neoplasms, or cerebrovascular diseases. In developed countries, toxoplasma encephalitis (TE) is the most frequent cause, followed by primary CNS lymphoma (PCNSL). Guidelines based on these causes however are poorly suited to developing countries, where treatable infections predominate as causes of HFBL.AIMTo determine a practical approach to the management of HFBL in developing countries.DESIGNCase series.METHODSPatients (n = 32) were managed based on presumed aetiologies of the focal brain lesions, determined by collating information from CT scans, CSF and blood studies, concurrent non-neurological illness and response to treatment.RESULTSThe principal presumed cause of HFBL was tuberculosis (69%). The therapeutic response was good in 69% of patients.DISCUSSIONIn developing countries, infections are the predominant cause of HFBL, the principal causes being infections that are endemic to the populations being studied. Empiric treatment based on limited investigations should be directed according to the nature of such infections. A modified algorithm is proposed.