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Catherine Leport, MD; Jean Louis Vilde, MD; Christine Katlama, MD; Bernard Regnier, MD; Sophie Matheron, MD; Adrien G. Saimot, MD
Claude Bernard Hospital University Paris VII

JAMA. 1986;255(17):2290.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Spiramycin, a macrolide widely used in Europe, has been shown to be active in humans in preventing transplacental infection.¹ It 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.² Spiramycin has therefore been suggested as an alternative treatment of toxoplasmosis in immunosuppressed patients, in view of its lack of hematologic toxicity.³ We report herein four cases of neurotoxoplasmosis in which this macrolide failed to prevent neurotoxoplasmosis in immunosuppressed patients.

Report of Cases.—

CASE 1.—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 gondii antibody 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 . . . [Full Text PDF of this Article]

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