Failure of Spiramycin to Prevent Neurotoxoplasmosis in Immunosuppressed Patients

Publisher Website
Google Scholar
Abstract
To the Editor.— Spiramycin, a macrolide widely used in Europe, has been shown to be active in humans in preventing transplacental infection.1It has never been assessed in the treatment of neurotoxoplasmosis in immunosuppressed patients. The recommended regimen of pyrimethamine and sulfadiazine has produced hematologic toxicity and may require discontinuation of therapy.2Spiramycin has therefore been suggested as an alternative treatment of toxoplasmosis in immunosuppressed patients, in view of its lack of hematologic toxicity.3We report herein four cases of neurotoxoplasmosis in which this macrolide failed to prevent neurotoxoplasmosis in immunosuppressed patients. Report of Cases.— Case1.—A 35-year-old homosexual man had the acquired immunodeficiency syndrome (AIDS). Results of neurological and brain scan examinations were normal. Because of high anti-Toxoplasma gondiiantibody titers (5,000 IU/mL) he was given oral spiramycin, 2 g/day. Sixteen days later, he experienced focal neurological signs and neurotoxoplasmosis was confirmed by specific immunoperoxidase

This publication has 2 references indexed in Scilit: