Sequential disseminated tuberculosis and toxoplasmosis in a Haitian refugee

A 27-year-old previously healthy male Haitian had sequential disseminated tuberculosis and toxoplasmosis during a three-month period. The former appeared to respond to antituberculous therapy; the latter proved fatal and was diagnosed only at autopsy. We suspect acquired immune deficiency syndrome (AIDS) as the underlying problem, which emphasizes the danger of sequential unusual infections in patients from groups with a high incidence of AIDS. This case also illustrates some of the difficulties of diagnosing toxoplasmosis and the advisability of early empiric therapy in such patients.