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Related Experiment Videos

Toxoplasmic chorioretinitis and hepatic granulomas.

T J Ortego1, B Robey, D Morrison

  • 1Department of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock.

The American Journal of Gastroenterology
|October 1, 1990
PubMed
Summary

A 71-year-old man with fever and weight loss was diagnosed with toxoplasmosis. His liver function improved spontaneously, indicating a self-limiting course for this opportunistic infection.

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Area of Science:

  • Infectious Diseases
  • Hepatology
  • Ophthalmology

Background:

  • Toxoplasma gondii is an opportunistic pathogen that can cause systemic illness in immunocompetent individuals.
  • Hepatic and ocular manifestations can occur in toxoplasmosis.
  • Differential diagnosis of fever, malaise, and elevated liver enzymes is broad.

Observation:

  • A 71-year-old male presented with a 2-month history of fever, malaise, and weight loss.
  • Physical examination revealed chorioretinitis, and laboratory studies showed elevated liver enzymes.
  • Serological testing confirmed high immunoglobulin G titers for Toxoplasma gondii, with negative results for other infectious agents.

Findings:

  • Liver biopsy revealed hepatic granulomas, but cultures for mycobacteria and fungi were negative.

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  • The patient experienced spontaneous improvement in clinical and laboratory parameters over 4 months.
  • These findings are consistent with a diagnosis of acquired toxoplasmosis.

    • Implications:

    • This case highlights the importance of considering toxoplasmosis in the differential diagnosis of unexplained fever, weight loss, and liver enzyme abnormalities, even in immunocompetent individuals.
    • Ocular involvement (chorioretinitis) can be a presenting sign of systemic toxoplasmosis.
    • The self-limiting nature of the illness in this patient suggests that not all cases of acquired toxoplasmosis require specific antiparasitic treatment.