BackgroundAcquired toxoplasmosis more frequently goes unrecognized. Immunocompetent adults and adolescents with primary infection are generally asymptomatic, but symptoms may include malaise, fever, and lymphadenopathy. By contrast, immunocompromised patients may experience severe manifestations including encephalitis and multisystem organ failure.Case presentationWe report a case of polymyositis and myocarditis in a 13-year old immunocompetent girl with toxoplasmosis. The patient presented with proximal muscle weakness, dysphagia, palms and soles rash and elevated serum levels of muscle enzymes, with liver and myocardial involvement. The diagnosis of toxoplasmosis was confirmed by serology. The patient was treated with prednisolone and had an excellent outcome. During a follow-up period of four years no relapses occurred and antibody levels to the T. gondii significantly decreased.ConclusionsAlthough several previous cases of toxoplasmosis occuring in association with polymyositis have been described in the literature such a wide spectrum of acute toxoplasmosis is rather unusual in immunocompetent adolescents. The relationship between T. gondii and polymyositis remains obscure. Appropriate investigation should be performed in every case of polymyositis not only for the appropriate treatment but also for further elucidation of this relationship.
A 6-y-old girl developed fever, soft-tissue mass in the right chest wall, osteomyelitis of the 10th rib and hepatic granuloma. Cat scratch disease was diagnosed by histological examination of the mass and serological tests. The patient was treated successfully with antibiotics and recovered completely, as shown by a 10 month follow-up.
Background: The Inborn Errors of Metabolism (IEM) are far from the rare systemic diseases that mainly affect the neural tissue. There are very few written reports on ocular findings in subjects with IEM, thus it was interesting to study the frequency of ocular findings in the studied population and explore their contribution to the early diagnosis of IEM.
12 months later, the patient was readmitted with fever (38.5uC), dyspnoea and cough for 2 days. He appeared ill. His body temperature was 36.7uC, respiratory rate was 26 breaths?min -1 , pulse was 108 beats?min -1 and O 2 saturation was 93%. On chest auscultation, he had decreased breath sounds over the right hemi-thorax. S 1 and S 2 cardiac sounds were normal with no murmur and the rest of examination was normal.His chest radiography (CXR) on admission is shown in figure 1.
12 months later, the boy was readmitted to the hospital for gradually increasing productive cough for 9 days and fever (up to 39.5uC) for 3 days.He was in good condition. His blood temperature was 38uC, respiratory rate was 24 breaths?min -1 , heart rate was 120 beats?min -1 and O 2 saturation was 91%. On chest auscultation he had decreased breath sounds over the right lower hemithorax. Cardiac examination was normal, throat examination showed small exudates on tonsils and review of remaining systems was normal.Chest radiograph (CXR) is shown in figure 1.
A 6-yr-old boy was admitted to the paediatric department of the University of Heraklion (Heraklion, Greece) with fever (38.5uC), respiratory distress and had been coughing for 2 days. He was well prior to admission.His past medical history was remarkable for frequent episodes of bronchiolitis and bronchitis from age 7 months until 3 yrs, followed by one episode of bronchitis per year, thereafter. In the second day of life, he was hospitalised for tachypnoea, attributed to laryngomalacia. He was full-term, born by caesarean section, due to decreased heart sounds. His neonatal history was negative. He is the oldest of four healthy siblings. His family history is negative.On physical examination, the boy was slightly pale, had tachypnoea and respiratory distress. He was well-developed and nourished. His temperature was 37uC, respiratory rate was 28 breaths?min -1 , pulse was 117 beats?min -1 and O 2 saturation was 87%. Chest auscultation revealed decreased breath sounds and crackles over the right lower hemi-thorax. His cardiac sounds S 1 and S 2 were normal. His throat was slightly congested. The rest of his physical examination was normal.His chest radiography (CXR) is shown in fig. 1.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.