Recent studies have defined the incidence of severe toxoplasmosis in heart transplant and AIDS patients and the indications for diagnostic brain biopsy. Pyrimethamine plus sulphadiazine remains the most effective combination for acute therapy. Specific prophylaxis reduces the incidence of toxoplasma in selected immune suppressed groups, and failure is associated with non-compliance or poor absorption. Atovaquone can be used as a second-line prophylactic agent.
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