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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
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.
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.
- 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.