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[Disseminated toxoplasmosis in AIDS]

A Holch1, M Opravil, D Moradpour

  • 1Abteilung Infektiologie, Universitätsspital, Zürich.

Deutsche Medizinische Wochenschrift (1946)
|June 4, 1993
PubMed
Summary

A 46-year-old HIV-positive man experienced multiple infections, ultimately succumbing to disseminated toxoplasmosis and cytomegalovirus. This case highlights the severe consequences of immunosuppression in advanced HIV infection.

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Area of Science:

  • Infectious Diseases
  • Immunology
  • Pathology

Background:

  • Human Immunodeficiency Virus (HIV) infection leads to profound immunosuppression.
  • Opportunistic infections are a major cause of morbidity and mortality in advanced HIV.

Observation:

  • A 46-year-old HIV-positive man presented with Pneumocystis pneumonia, Candida esophagitis, and recurrent herpes simplex. He developed unexplained fever, pancytopenia, and organ damage.
  • Initial diagnostic workup was inconclusive, but symptoms temporarily improved with co-trimoxazole.
  • Deterioration occurred with neurological symptoms and new laboratory abnormalities, leading to death.

Findings:

  • Autopsy revealed widespread Toxoplasma gondii pseudocysts and necrotizing inflammation in multiple organs, including the brain, heart, lungs, and gastrointestinal/urogenital tracts.

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  • Cytomegalovirus infection was also identified in the lungs and adrenal glands.
  • Postmortem serology showed a significant rise in anti-Toxoplasma IgG antibodies, indicating reactivation.

    • Implications:

    • Disseminated toxoplasmosis can be a fatal opportunistic infection in severely immunocompromised individuals with HIV.
    • Reactivation of latent Toxoplasma gondii is a critical concern in the context of advanced HIV.
    • This case underscores the importance of considering and diagnosing opportunistic infections, including toxoplasmosis, in HIV patients with complex clinical presentations.