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[Pulmonary toxoplasmosis in AIDS. Report of 3 cases]
L Knani1, K Bouslama, C Varette
1Service de Médecine Interne, Hôpital Saint-Antoine, Paris.
Abstract:
Pulmonary toxoplasmosis in AIDS is rare. Its frequency is estimated to be between 0.2 and 3.7% but is probably underestimated; however, it is lower than that of neurotoxoplasmosis and is rarely identified prior to autopsy. We describe herein 3 cases diagnosed in living patients. The clinical presentation is usually severe interstitial pneumonitis, occurring in profoundly immunodeficient patients. Toxoplasma gondii, the infectious agent, must always be sought in the bronchoalveolar lavage of such patients and is sometimes associated with other opportunistic infectious agents, such as Pneumocystis carinii.
Insights
Pulmonary toxoplasmosis, a rare complication in AIDS patients, often presents as severe pneumonitis. Early diagnosis in bronchoalveolar lavage is crucial for timely treatment of this opportunistic infection.
Area of Science:
- Infectious Diseases
- Pulmonology
- Immunology
Background:
- Pulmonary toxoplasmosis is an uncommon opportunistic infection in patients with Acquired Immunodeficiency Syndrome (AIDS).
- Its prevalence is estimated between 0.2-3.7%, potentially underestimated, and less frequent than neurotoxoplasmosis.
- Diagnosis is often made post-mortem, highlighting challenges in antemortem identification.
Observation:
- This report details three cases of pulmonary toxoplasmosis diagnosed in living patients with AIDS.
- The clinical manifestation typically involves severe interstitial pneumonitis.
- These cases occurred in individuals with profound immunodeficiency.
Findings:
- Toxoplasma gondii should be actively investigated in bronchoalveolar lavage fluid from immunocompromised patients presenting with pneumonitis.
- Pulmonary toxoplasmosis can co-occur with other opportunistic infections, such as Pneumocystis carinii pneumonia.
- Successful antemortem diagnosis was achieved in the presented cases.
Implications:
- Emphasizes the importance of considering and testing for pulmonary toxoplasmosis in severely immunocompromised patients, particularly those with AIDS and pneumonitis.
- Highlights the diagnostic utility of bronchoalveolar lavage in identifying Toxoplasma gondii.
- Suggests that earlier diagnosis and treatment can improve outcomes for this rare but serious opportunistic infection.