[Latar Belakang: Ensefalitis toksoplasma (ET) termasuk infeksi oportunistik yang
paling banyak menyebabkan penyakit SSP pasien AIDS. Algoritma penatalaksanaan
lesi fokal otak ET pasien AIDS di Rumah Sakit Cipto Mangunkusumo (RSCM)
masih berdasarkan terapi empiris ET. Tujuan: Mengetahui proporsi pasien AIDS
diduga ET yang menunjukkan perbaikan klinis dan atau radiologis setelah diberikan
terapi empiris dan faktor-faktor yang mempengaruhi. Metode: Studi retrospektif
potong lintang melalui data rekam medis pasien AIDS dewasa diduga klinis ET rawat
inap pertama kali di RSCM dari tahun 2010-2012 dengan CD4 <200sel/mm3.
Perbaikan klinis dan atau radiologis dinilai setelah 2 minggu terapi empiris. Hasil:
Didapatkan 82 subyek, dengan perbaikan klinis pada 63 pasien (77%). Terdapat 20
subyek yang menjalani pencitraan evaluasi dan dapat dibandingkan.Enam belas di
antaranya didapatkan perbaikan radiologis. Median usia subyek 30 tahun (23-51) dan
nilai median CD4 21 sel/mm3 (3-152). Penyakit penyerta terbanyak adalah
tuberkulosis (46.3%), pneumonia (40.2%), dan sepsis (22%). Subyek tanpa sepsis
memberikan respons yang lebih baik secara nyata dibandingkan subyek dengan sepsis
(p= 0,000). Kesimpulan: Pemberian terapi empiris pada pasien yang diduga ET
secara klinis masih menghasilkan respons klinis dan atau radiologis yang baik. Sepsis
menurunkan secara bermakna respons terhadap terapi empiris., Background: Toxoplasma encephalitis (TE) is one of opportunistic infections that
most cause CNS disease in AIDS and leads to focal brain lesions. The algorithm
management of focal brain lesions AIDS patients in Cipto Mangunkusumo Hospital
(RSCM) was based on empirical therapy of TE. Aim: To find out the proportion of
AIDS patients in RSCM with clinical diagnosis of TE who showed clinical and or
radiological improvement after administration of empirical therapy and the
influencing factors. Method: A retrospective, cross-sectional study using medical
records of adult AIDS patients admitted in RSCM from year 2010–2012. The eligible
subjects were those who were admitted with clinical diagnosis of TE for the first time
and CD4 <200cells/mm3. Clinical and or radiological improvement was assessed
after two weeks of empirical therapy. Results: There were 82 eligible subjects.
Clinical improvement was found in 63 subjects (77%). There were 20 subjects who
undergone serial neuroimaging examination and have comparable result. Sixteen
subjects showed radiological improvement. Median age of the subjects was 30 years
old (23–51) and median CD4 was 21cells/mm3 (3–152).The most frequent
comorbidities were tuberculosis (46.3%), pneumonia (40.2%), and sepsis(22%).
Subjects without sepsis were more responsive to empirical therapy compared to
subjects with sepsis (p= 0.00).Conclusions: Administration of empirical therapy in
patients clinically diagnosed with TE provided favourable clinical and or radiological
responses. Sepsis was associated with poor response to empirical therapy.]
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