Toxoplasmosis

1991 ◽  
Vol 12 (8) ◽  
pp. 227-236
Author(s):  
Bishara J. Freij ◽  
John L. Sever
Keyword(s):  
Mononuclear Cells ◽  
Developmental Stages ◽  
Clinical Manifestations ◽  
Protozoan Parasite ◽  
Treatment Modalities ◽  
North African ◽  
Obligate Intracellular ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Toxoplasma gondii is an obligate intracellular parasite capable of infecting humans and a variety of other warm-blooded animals. The organism is distributed widely in nature and may infect as many as 1 of 3 persons worldwide. Most Toxoplasma infections are either asymptomatic or otherwise benign; notable exceptions include the infections of the developing fetus whose mother acquires an acute T gondii infection during gestation and of immunosuppressed patients, such as those with the acquired immunodeficiency syndrome (AIDS), in whom the illness may be severe or even fatal. The cat and other felines (such as the lynx) appear to be the only definitive hosts for this protozoan. The name Toxoplasma is derived from the Greek word toxon (meaning arc or bow) and is a reference to the shape of the organism. The gondi is a North African desert rodent related to the gerbil in whose splenic and hepatic mononuclear cells the parasite was observed initially. This article briefly reviews the biology of T gondii and its epidemiology in man and other animals, as well as its pathogenesis, clinical manifestations, methods for accurate diagnosis, and preventive strategies. Information on prenatal diagnosis and treatment modalities is emphasized. THE ORGANISM T gondii is a protozoan parasite that exists in three developmental stages: tachyzoite, tissue cyst, and oocyst.

Gastric Toxoplasmosis as the Presentation of Acquired Immunodeficiency Syndrome

2005 ◽  
Vol 129 (4) ◽  
pp. e87-e90 ◽  
Author(s):  
Mihai Merzianu ◽  
Steven M. Gorelick ◽  
Voltaire Paje ◽  
Donald P. Kotler ◽  
Corazon Sian
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
English Literature ◽  
Human Immunodeficiency Virus Status ◽  
Old West ◽  
Immunosuppressed Patients ◽  
The Central Nervous System ◽  
Acquired Immunodeficiency ◽  
High Index Of Suspicion ◽  
Immunodeficiency Syndrome ◽  
Disseminated Disease

Abstract We report a case of a 39-year-old West African man with unknown human immunodeficiency virus status diagnosed with gastric toxoplasmosis as the presenting manifestation of acquired immunodeficiency syndrome. Toxoplasma gondii is common in severely immunosuppressed patients and most frequently involves the central nervous system, followed by the eye, myocardium and skeletal muscle, lungs, bone marrow, and peripheral blood. For unclear reasons, gastrointestinal involvement is exceedingly rare and occurs in the context of severe immunosuppression and disseminated disease. To our knowledge, this is the first report in the English literature of a patient with isolated, manifest gastric toxoplasmosis without evidence of concomitant cerebral or extracerebral involvement. It is important for both the clinician and the pathologist to maintain a high index of suspicion for toxoplasmosis in immunosuppressed patients presenting with nonspecific symptoms of gastritis and radiologic and endoscopic presence of thickened gastric folds with or without ulceration.

Treatment of Severe Cryptosporidium-Related Diarrhea with Octreotide in a Patient with AIDS

1988 ◽  
Vol 22 (2) ◽  
pp. 134-136 ◽  
Author(s):  
Michael D. Katz ◽  
Brian L. Erstad ◽  
Cathryn Rose
Keyword(s):  
Gastrointestinal Hormones ◽  
Somatostatin Analog ◽  
Secretory Diarrhea ◽  
Inhibitory Effects ◽  
Severe Diarrhea ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Antiparasitic Drugs ◽  
Long Acting ◽  
Immunodeficiency Syndrome

Cryptosporidiosis commonly causes severe diarrhea in immunosuppressed patients. There currently are no antiparasitic drugs consistently effective for this infection. This case describes a 26-year-old hemophiliac patient with acquired immunodeficiency syndrome and cryptosporidiosis whose diarrhea improved with continuous intravenous administration of a long-acting somatostatin analog, octreotide. Somatostatin has a variety of inhibitory effects on gastrointestinal hormones as well as a possible nonspecific effect on gastrointestinal mucosal fluid and electrolyte secretion. The somatostatin analog should be considered for patients with secretory diarrhea refractory to other forms of therapy.

scholarly journals A Case Report of Acute Severe Myelitis and Meningitis Secondary to Varicella Zoster Virus Reactivation in a Patient with Acquired Immunodeficiency Syndrome

2021 ◽  
Author(s):  
Victor A Novelo-Hernández ◽  
Marco Cárdenas ◽  
Claudia Torres-González ◽  
Patricio Garcia-Espinosa ◽  
Rómulo Ramirez ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Varicella Zoster Virus ◽  
Acquired Immunodeficiency Syndrome ◽  
Clinical Manifestations ◽  
Virus Reactivation ◽  
Neck Stiffness ◽  
Varicella Zoster ◽  
Wide Range ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

Background: Myelitis post Herpes-Zoster is a rare condition that is typically associated with immunocompromised states. It usually starts as an acute loss of sensory and motor functions below the affected spinal cord level. The condition can range in severity from a mild to a fatal presentation. Other neurological complications include meningitis, atypical presentations should encourage the search for undiagnosed immunosuppression states. The Case: We describe the case of a 42-year-old man, previously undiagnosed with HIV, who developed acute myelitis and meningitis after the appearance of the classic zoster lesions. On lumbar puncture and subsequent CSF analysis, the patient was found to have Froin’s Syndrome. The patient was initiated with ceftriaxone, vancomycin, and acyclovir regimen and prophylactic antiphymic treatment was also added. After 14 days in the hospital, the fever, headache, and neck stiffness subsided while the sphincter function and lower limb paraplegia did not improve.   Conclusion: Varicella zoster virus reactivation suggests underlying immunosuppression. This case demonstrates the importance of being cognizant to the wide range of clinical manifestations that may suggest spinal cord involvement after clinical reactivation. Furthermore, physicians also need to be mindful that Acquired Immunodeficiency Syndrome (AIDS) and other immunodeficiency states could present with atypical clinical manifestations.

scholarly journals Fungal Mastoiditis in AIDS Patients: Reported Cases

2011 ◽  
Vol 15 (02) ◽  
pp. 245-248
Author(s):  
Flavia Silveira ◽  
Gabriel Bijos Faidiga ◽  
Tassiana do Lago ◽  
Camila Carrara Yassuda ◽  
Eduardo Tanaka Massuda ◽  
...  
Keyword(s):  
Case Report ◽  
Facial Nerve ◽  
Antifungal Therapy ◽  
Acquired Immunodeficiency Syndrome ◽  
Aids Patients ◽  
Aspergillus Fumigates ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome ◽  
Fatal Complications

Summary Introduction: Fungal mastoidits by Aspergillus fumigates predominantly occurs in immunosuppressed patients. Diagnosis is usually hard and disease is potentially fatal. Treatment is comprised of antifungal therapy, surgical debridement and immunosuppression correction. Case Report: This article reports a case of fungal mastoiditis in a patient with acquired immunodeficiency syndrome (AIDS). The treatment performed was that of surgery associated with antifungal therapy. The patient's facial nerve was not affected, what does not exclude potentially fatal complications of mastoiditis.

BK Virus Renal Infection in a Patient With the Acquired Immunodeficiency Syndrome

1999 ◽  
Vol 123 (9) ◽  
pp. 807-811 ◽  
Author(s):  
Manuela Nebuloni ◽  
Antonella Tosoni ◽  
Renzo Boldorini ◽  
Guido Monga ◽  
Luca Carsana ◽  
...  
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Renal Damage ◽  
Bk Virus ◽  
Transplant Patients ◽  
Immunosuppressed Patients ◽  
Acquired Immunodeficiency ◽  
Polymerase Chain ◽  
Immunodeficiency Syndrome ◽  
Inflammatory Infiltrates ◽  
Renal Infection

Abstract Background.—We describe herein a patient with the acquired immunodeficiency syndrome and renal failure due to biopsy-proven BK virus (BKV) infection. Three months after the diagnosis of the renal viral infection, his condition remained unchanged. Although BKV has previously been shown to be associated with ureteral stenosis and renal damage in renal transplant patients, to our knowledge, the literature contains only 3 cases describing the presence of BKV lesions in the kidneys of immunosuppressed patients who had not undergone transplantation. Methods.—The presence of BKV infection was demonstrated by means of histology, immunohistochemistry with polyclonal anti-SV40 antibody, immunoelectron microscopy, polymerase chain reaction, and enzymatic cleavage with BamHI. Results.—Histologic examination revealed interstitial inflammatory infiltrates and tubules with enlarged and eosinophilic nuclei. Conclusions.—The high frequency of latent BKV infection and its reactivation during immunosuppression suggest that the possibility of its involvement in renal damage should be considered in immunocompromised patients.

Rapid Death of Adoptively Transferred T Cells in Acquired Immunodeficiency Syndrome

Blood ◽  
1999 ◽  
Vol 93 (5) ◽  
pp. 1506-1510 ◽  
Author(s):  
Rusung Tan ◽  
Xiaoning Xu ◽  
Graham S. Ogg ◽  
Pokrath Hansasuta ◽  
Tao Dong ◽  
...  
Keyword(s):  
T Cell ◽  
Adoptive Transfer ◽  
Acquired Immunodeficiency Syndrome ◽  
Mononuclear Cells ◽  
Virus Load ◽  
Acquired Immunodeficiency ◽  
Peptide Complexes ◽  
Immunodeficiency Syndrome

Human immunodeficiency virus (HIV)-specific cytotoxic T lymphocytes (CTL) probably play the major role in controlling HIV replication. However, the value of adoptive transfer of HIV-specific CTL expanded in vitro to HIV+ patients has been limited: this contrasts with the success of CTL therapy in treating or preventing Epstein-Barr virus and cytomegalovirus disease after bone marrow transplantation (BMT). We investigated the fate of expanded HIV-specific CTL clones in vivo following adoptive transfer to a patient with acquired immunodeficiency syndrome (AIDS). Two autologous CTL clones specific for HIV Gag and Pol were expanded to large numbers (>109) in vitro and infused into an HIV-infected patient whose viral load was rising despite antiretroviral therapy. The fate of one clone was monitored by staining peripheral blood mononuclear cells (PBMCs) with T-cell receptor–specific tetrameric major histocompatibility complex (MHC)-peptide complexes. Although the CTL transfer was well tolerated, there were no significant changes in CD4 and CD8 lymphocyte counts and virus load. By tracking an infused clone using soluble MHC-peptide complexes, we show that cells bearing the Gag-specific T-cell receptors were rapidly eliminated within hours of infusion through apoptosis. Thus, the failure of adoptively transferred HIV-specific CTL to reduce virus load in AIDS may be due to rapid apoptosis of the infused cells, triggered by a number of potential mechanisms. Further trials of adoptive transfer of CTL should take into account the susceptibility of infused cells to in vivo apoptosis.

scholarly journals Aids-related progressive multifocal leukoencephalopathy: a retrospective study in a referral center in São Paulo, Brazil

2008 ◽  
Vol 50 (4) ◽  
pp. 209-212 ◽  
Author(s):  
José E. Vidal ◽  
Augusto C. Penalva de Oliveira ◽  
Maria Cristina D. S. Fink ◽  
Cláudio S. Pannuti ◽  
J. Roberto Trujillo
Keyword(s):  
Progressive Multifocal Leukoencephalopathy ◽  
Opportunistic Infections ◽  
Neurological Diseases ◽  
Clinical Manifestations ◽  
Sao Paulo ◽  
São Paulo ◽  
Referral Center ◽  
Acquired Immunodeficiency ◽  
Few Data ◽  
Immunodeficiency Syndrome

Few data are available about progressive multifocal leukoencephalopathy (PML) in patients with acquired immunodeficiency syndrome (AIDS) from Brazil. The objectives of this study were to describe the main features of patients with PML and estimate its frequency among AIDS patients with central nervous system (CNS) opportunistic diseases admitted to the Instituto de Infectologia Emílio Ribas, São Paulo, Brazil, from April 2003 to April 2004. A retrospective and descriptive study was performed. Twelve (6%) cases of PML were identified among 219 patients with neurological diseases. The median age of patients with PML was 36 years and nine (75%) were men. Nine (75%) patients were not on antiretroviral therapy at admission. The most common clinical manifestations were: focal weakness (75%), speech disturbances (58%), visual disturbances (42%), cognitive dysfunction (42%), and impaired coordination (42%). The median CD4+ T-cell count was 45 cells/µL. Eight (67%) of 12 patients were laboratory-confirmed with PML and four (33%) were possible cases. Eleven (92%) presented classic PML and only one case had immune reconstitution inflammatory syndrome (IRIS)-related PML. In four (33%) patients, PML was the first AIDS-defining illness. During hospitalization, three patients (25%) died as a result of nosocomial pneumonia and nine (75%) were discharged to home. Cases of PML were only exceeded by cases of cerebral toxoplasmosis, cryptococcal meningoencephalitis, and CNS tuberculosis, the three more frequent neurologic opportunistic infections in Brazil. The results of this study suggest that PML is not an uncommon HIV-related neurologic disorder in a referral center in Brazil.

Activation of monocyte-mediated tumoricidal activity in patients with acquired immunodeficiency syndrome.

1985 ◽  
Vol 3 (7) ◽  
pp. 1005-1012 ◽  
Author(s):  
E S Kleinerman ◽  
L M Ceccorulli ◽  
L A Zwelling ◽  
T Twilley ◽  
R B Herberman ◽  
...  
Keyword(s):  
Acquired Immunodeficiency Syndrome ◽  
Mononuclear Cells ◽  
Human Tumor ◽  
Target Cells ◽  
Aids Patients ◽  
Tumoricidal Activity ◽  
Ifn Gamma ◽  
Acquired Immunodeficiency ◽  
Immunodeficiency Syndrome

The purpose of these studies was to determine whether peripheral blood monocytes from acquired immunodeficiency syndrome (AIDS) patients with Kaposi's sarcoma could be activated to lyse human tumor target cells in vitro. Monocytes were isolated and incubated for 24 hours in vitro with either medium (control), a crude mitogen-induced lymphokine preparation (MAF), or endotoxin before the addition of [125I]IUdR-labeled A375 melanoma target cells. Cytolysis was determined 72 hours later. Twelve (100%) of 12 patients tested had monocyte-mediated cytotoxicity values that were comparable to those of normal individuals. Recombinant human gamma interferon (IFN gamma) activated both normal and AIDS monocyte-mediated tumoricidal function only when combined with lypopolysaccharide (LPS). In addition, mononuclear cells from ten AIDS patients were also tested for their ability to secrete MAF and IFN gamma in response to a mitogenic stimulus. Lymphokines generated from all ten patients contained substantial amounts of IFN gamma (100 to 2,500 U/mL); however, three of these ten lymphokine preparations failed to activate normal monocytes to lyse tumor cells. These results suggest that monocyte-mediated tumoricidal function of AIDS patients is intact and thus suggest new approaches for the therapy of AIDS.

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