Related Experiment Videos
Pulmonary toxoplasmosis: a review.
1Infectious Disease Section, Veterans Affairs Medical Center, Minneapolis, Minnesota 55417.
Summary
Toxoplasma pneumonia, caused by Toxoplasma gondii, affects both immunocompetent and immunocompromised individuals, particularly those with AIDS. Early diagnosis and treatment are crucial, though relapses are common, especially in immunosuppressed patients.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunology
Background:
- Toxoplasma gondii is an opportunistic pathogen increasingly recognized as a cause of pneumonia, especially in patients with Acquired Immunodeficiency Syndrome (AIDS).
- Understanding the distinct clinical presentations and outcomes in different patient populations is essential for effective management.
Purpose of the Study:
- To review and synthesize existing literature on postnatally acquired Toxoplasma pneumonia.
- To identify distinct clinical syndromes, diagnostic methods, and patient outcomes associated with Toxoplasma gondii pneumonia.
Main Methods:
- A comprehensive literature review of English-, French-, and Spanish-language publications from January 1966 to February 1991.
- Inclusion of cases of pneumonia associated with Toxoplasma gondii, analyzing clinical, radiological, serological, and pathological data.
Main Results:
- Two distinct clinical syndromes were identified: one in immunocompetent patients and another in those with impaired cell-mediated immunity.
- Common symptoms included shortness of breath and cough; common signs included fever and rales. Lymphadenopathy and hepatosplenomegaly were more frequent in immunocompetent patients.
- Mortality for toxoplasma pneumonia was 55% overall, but 0% in immunocompetent patients and 40% in immunosuppressed patients when diagnosed during life. Antitoxoplasma therapy improved outcomes in immunosuppressed patients, but relapses were frequent. Subclinical pulmonary involvement was noted in 33% of patients with disseminated toxoplasmosis.
Conclusions:
- Toxoplasma pneumonia presents differently in immunocompetent versus immunosuppressed individuals.
- Prompt diagnosis, particularly via bronchoalveolar lavage, and specific antitoxoplasma therapy are vital for improving survival in immunosuppressed patients, despite the risk of relapse.