Fulminant Disseminated Toxoplasmosis in an HIV Patient

Abstract

Disseminated toxoplasmosis in AIDS is a rare condition. We present an unusual case of a fulminant form of disseminated toxoplasmosis in a young male homosexual. He was a 30-year-old HIV-positive (diagnosed 4 months earlier), admitted with a 5-day history of diarrhea, vomiting, fever, and cough. He had been generally healthy except for an 8-week history of weight loss and malaise. On admission, except for a temperature of 37.6 degrees C, the physical examination was normal. He was treated symptomatically. Four days after admission he suddenly became short of breath. Despite intensive management, he continued to deteriorate and expired 6 h later. Postmortem examination revealed disseminated toxoplasmosis involving the heart, lungs, brain, stomach, small intestine, and colon. This is an unusual presentation of disseminated toxoplasmosis because of its rapid course with no prior indication of infection. To our knowledge, such an atypical and rapid downhill course of toxoplasmosis (with minimal clinical and laboratory features) has not been reported previously. Increased awareness of this infection in all HIV patients and its possibly rapid course is needed.

Disseminated Toxoplasmosis in a Patient with Undiagnosed Aids

“…In both patients, clinical and laboratory findings were similar to findings for sepsis or septic shock, and death occurred quickly (6). Al-Kassab et al reported similar findings in an HIV patient with a normal clinical examination and normal chest x-ray at presentation but with acute respiratory distress and demise within 5 days (10). A similar patient with acute disseminated T. gondii infection with massive organ involvement during primary HIV infection was also described by Signorini et al (11).…”

Fatal Disseminated Toxoplasmosis During Primary HIV Infection

“…The occurrence of these conditions has been attributed to the transient but profound immune depression which is associated to acute HIV infection. Toxoplasmosis is a well recognized manifestation of AIDS, but the disseminated disease is a rare condition [1]. We describe a case of disseminated toxoplasmosis during primary HIV infection.…”

Suspected toxoplasma—Associated myocarditis in a cat

“…Toxoplasmosis has been reported to cause myocarditis in man, but the majority of reports are limited to immunocompromised individuals (Al-Kassab et al 1995), typically following transplantation (Mayes et al 1995, Gallino et al 1996, Hermanns et al 2001. Similar reports are rare in the cat.…”