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Oral ganciclovir may be effective in preventing cytomegalovirus (CMV) retinitis in AIDS patients. CMV retinitis is a common complication of AIDS, occurring in 25% to 40% of patients. Of 725 AIDS patients with blood tests positive for CMV, 486 took 1,000 milligrams of oral ganciclovir three times a day and 239 took a placebo. They were treated for an average of 240 to 269 days. At 12 months, 14% of those who took ganciclovir developed CMV disease compared to 26% of the placebo group. Twelve percent of those taking ganciclovir had developed CMV retinitis at one year, compared to 24% of the placebo group. At the start of the study, 41% of those assigned to ganciclovir tested positive for antibodies to CMV compared to 44% of those assigned to placebo. Two months later, only 10% of the ganciclovir group tested positive, compared to 43% of the placebo group. At one year, 21% of the ganciclovir group had died compared to 26% of the placebo group. More than half the patients in each group dropped out of the study.

Neurocysticercosis due to parenchymal cysts carries a good prognosis regardless of therapy. Extraparenchymal neurocysticercosis (including ventricular, spinal, and subarachnoid types) carries a poorer prognosis. Most extraparenchymal cases present with hydrocephalus. Medical treatment alone in doses and schedules developed for parenchymal disease is frequently unsuccessful. For ventricular disease, most cases can be managed with shunting procedures either alone or together with the administration of antiparasitic agents (e.g., praziquantel or albenda-zole), without extirpation of the cysts. Subarachnoid disease was formerly associated with a case fatality rate of about 50%. However, with the combination of shunting procedures for hydrocephalus, antiparasitic agents, and, in some cases, surgical extirpation of the cysts, the prognosis is much improved. Spinal cysticercosis can be either leptomeningeal (which responds like subarachnoid disease) or intramedullary. For all forms of neurocysticercosis, the role of antiparasitic agents needs to be better defined. [ABSTRACT FROM PUBLISHER]

Describes a patient with the first well-documented case of isoniazid-induced acute pancreatitis. Background on the case report; Discussion on the case.