Reply to Gómez‐Marín

Ajzenberg, Daniel; Yera, Hélène; Marty, Pierre; Paris, Luc; Dalle, Frédéric; Menotti, Jean; Aubert, Dominique; Franck, Jacqueline; Bessières, Marie-Hélène; Quinio, Dorothée; Pelloux, Hervé; Delhaès, Laurence; Desbois, N.; Thulliez, P.; Robert‐Gangneux, Florence; Kauffmann‐Lacroix, C.; Pujol, Sophie; Rabodonirina, Méja; Bougnoux, Marie‐Elisabeth; Cuisenier, B.; Duhamel, Chantal; Duong, Thanh Haï; Filisetti, Denis; Flori, Pierre; Gay-Andrieu, Françoise; Pratlong, Francine; Nevez, Gilles; Totet, Anne; Carme, Bernard; Dardé, Marie‐Laure; Villena, Isabelle

doi:10.1086/605415

Cited by 5 publications

(13 citation statements)

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“…Only one mismatch between AF179871 and an RH strain (C¡T at position 754) was detected in the 190 bp sequenced. A large study of immunocompromised patients showed that type III was the second most common genotype recovered from European patients, after type II (11). Our case is in accordance with the conclusion of that study, which reported the absence of a correlation between the parasite genotype and the site or outcome of the infection.…”

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confidence: 92%

“…Cutaneous toxoplasmosis is a rare finding, and vesicular lesions associated with toxoplasmosis have not been reported previously. Severe infections in immunocompromised patients usually result from the reactivation of latent cysts into invasive tachyzoites and may provoke severe symptoms such as encephalitis, ocular toxoplasmosis, pneumonia, and disseminated infection (7)(8)(9)(10)(11). Localized and sometimes disseminated varicella-zoster virus infection is observed in transplant patients (12).…”

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confidence: 99%

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Varicella-Like Cutaneous Toxoplasmosis in a Patient with Aplastic Anemia

et al. 2013

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A 60-year-old patient with aplastic anemia presented with vesicular varicella-like skin lesions on her face, arms, legs, back, and abdomen. However, diagnosis for herpetic infection was negative. Findings of a skin biopsy led to a tentative histologic diagnosis of toxoplasmosis, and infection with Toxoplasma gondii was confirmed by immunohistochemistry and PCR. Cutaneous toxoplasmosis is a rare finding in immunocompromised patients and might mimic other infectious diseases, and vesicular lesions associated with toxoplasmosis have not been reported previously. CASE REPORTA 60-year-old woman was diagnosed with aplastic anemia in April 2012 and referred to our hospital. Bone marrow analysis revealed highly deficient hematopoiesis and therapy with thymoglobulin, cyclosporin, and methylprednisolone was initiated. During her second week as an inpatient, a Clostridium difficile infection was treated with metronidazole. In week 4, the patient developed a fever due to a Klebsiella pneumoniae infection, as identified by a blood culture; additionally, cytomegalovirus (CMV) viremia was detected. In week 8, Stenotrophomonas maltophilia was detected in her sputum and therapy with cotrimoxazole was immediately initiated at 960 mg intravenously twice daily until the end of her hospital stay. In the further course, multiple disseminated small vesicles with little surrounding erythema were observed on the patient's face, arms, legs, back, and abdomen in week 8 of her hospital stay (Fig. 1A). Her C-reactive protein level increased to 415 mg/liter, the patient developed pneumonia, and thoracic computer tomography revealed images compatible with a fungal infection, i.e., infiltrates in the lungs, halo signs, and pulmonary nodules, typically seen in fungal pneumonia. This diagnosis was confirmed later when Rhizomucor pusillus was detected in a bronchoalveolar lavage specimen. Antifungal treatment with liposomal amphotericin was initiated, and mechanical ventilation was necessary because of respiratory failure. The patient died 10 weeks after admission.Varicella-like skin lesions were highly suggestive of a herpetic infection with herpes simplex virus or varicella-zoster virus. The patient reported having had herpes and chickenpox during childhood; thus, a primary infection with these herpesviruses was excluded and reactivation of a latent herpesvirus infection was suspected. However, skin swabs of affected areas and skin biopsy specimens were repeatedly negative for herpes simplex virus and varicella-zoster virus by PCR analysis. In the skin biopsy specimen, intracytoplasmic particles with the shape of parasites (Leishmania sp., Toxoplasma gondii) were detected histologically. No antibodies against Leishmania sp. were detectable; however, T. gondii infection was verified by PCR analysis of DNA extracted from lesion material targeting the B1 region and the AF146527 repetitive DNA element in the T. gondii genome. The histological changes in this case were subtle, with only a few organisms visualized within epidermal keratinocytes. Howe...

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confidence: 99%

Varicella-Like Cutaneous Toxoplasmosis in a Patient with Aplastic Anemia

et al. 2013

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“…genotype ToxoDB#10, #27 and #35), are more pathogenic and likely to cause severe disease (Xiao and Yolken, 2015). The results of the studies carried out by Howe and Sibley (1995) in North America and Ajzenberg et al (2009) in Europe showed that type II strains (genotype ToxoDB #1) were predominant among HIV-positive patients with toxoplasmic infection (Howe and Sibley, 1995;Ajzenberg et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Genetic characterization of Toxoplasma gondii in Iranian HIV positive patients using multilocus nested-PCR-RFLP method

Hosseini¹,

Sharif²,

Sarvi³

et al. 2019

Parasitology

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The aim of the present study was to investigate the prevalence and genotyping of Toxoplasma gondii in Iranian human immunodeficiency virus (HIV)-positive patients using multilocus-nested polymerase chain reaction restriction fragment length polymorphism (Mn-PCR-RFLP). A total of 102 serum samples obtained from infected patients were collected from the laboratory centres in northern Iran. Anti-T. gondii antibodies and deoxyribonucleic acid (DNA) detection were accomplished by an enzyme-linked immunosorbent assay and PCR. The Mn-PCR-RFLP method was used for the genotyping of T. gondii. Overall, 68.6% (70/102) and 11.7% (12/102) of the individuals were tested positive for anti-T. gondii immunoglobulin G and T. gondii DNA, respectively. Complete genotyping was performed on 10/12 (83.3%) PCR-positive samples. Accordingly, the samples were classified as genotype #1 (type II clonal; n = 3, 30%), genotype #2 (type III clonal; n = 2, 20%), genotype #10 (type I clonal; n = 2, 20%), genotype #27 (type I variant; n = 1, 10%), genotype #35 (type I variant; n = 1, 10%) and genotype #48 (type III variant; n = 1, 10%). The results were indicative of the high frequency of the type I and type I variant of T. gondii strains in HIV-positive patients in northern Iran. Given the high prevalence of T. gondii and frequency of pathogenic types (pathogen in laboratory mice) in the patients, special measures should be taken to prevent the possible increased incidence of encephalitis by T. gondii.

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“…Caribbean genotypes found in the anthropized areas of French Guiana and in several Caribbean Islands, or in Africa, where the same African lineages were found in different countries [169,170,171].…”

Section: The Wild Environment In Tropical Areasmentioning

confidence: 92%