Disseminated toxoplasmosis having hematologic involvement by bone marrow infiltration: a case report in a patient with HIV and brief review of coinfection

Toxoplasmosis diseminada con compromiso hematológico por infiltración de médula ósea: presentación de un caso en paciente con VIH y breve revisión de la coinfección

##plugins.themes.bootstrap3.article.main##

Johanna Osorio
Carolina Silva
Jonathan Toro
Jackeline Barreto
Abstract

Toxoplasma gondii is a common opportunist pathogen in patients with Acquired Immunodeficiency Syndrome (AIDS) Although its presentation is rare in geographic áreas with easy access to highly effective antiretroviral therapy (HAART). The usual clinical presentation involves the central nervous system, retina and respiratory tract. Toxoplasmosis with dissemination to bone marrow is uncommon in AIDS patients as evidenced in the few cases reported in the literature, most of them take place in patients after bone marrow transplant. Here it is described the case of a patient with a previous diagnosis of HIV infection and interruption of HAART who had fever and severe pancytopenia and who has documented pulmonary tuberculosis and toxoplasma tachyzoites presence in bone marrow aspirate. Toxoplasmosis disseminated to bone marrow should be considered as a differential diagnosis in patients with HIV,fever and hematologic involvement.

Keywords

Downloads

Download data is not yet available.

##plugins.themes.bootstrap3.article.details##

Author Biographies / See

Johanna Osorio, Hospital Universitario de Neiva, Colombia.

Grupo de investigación Infecto control, Hospital Universitario de Neiva, Colombia. Departamento de Medicina Interna, Facultad de Salud, Universidad Surcolombiana, Neiva, Colombia.

Carolina Silva, Universidad Surcolombiana

Patología, Hospital Universitario de Neiva, Colombia.

Jonathan Toro, Universidad Surcolombiana

Departamento de Medicina Interna, Facultad de Salud, Universidad Surcolombiana, Neiva, Colombia.

Jackeline Barreto, Hospital Universitario de Neiva, Colombia

Grupo de investigación Infecto control, Hospital Universitario de Neiva, Colombia.
References

Dubey JP. The history of Toxoplasma gondii-the first 100 years. Journal of Eukaryotic Microbiologyl. 2008;55(6):467-475. http://dx.doi.org/10.1111/j.1550-7408.2008.00345.x.

Kasper L, Courret N, Darche S, et al. Toxoplasma gondii and mucosal Immunity. International Journal for Parasitology 2004;34(3):401-409. http://dx.doi.org/ 10.1016/j.ijpara.2003.11.023

Montoya J, Boothroyd J. Toxoplasma gondii. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Vol. 2, 7th ed. Churchill Livingstone: An Imprint of Elsevier; 2010. Chapter 279: p. 3495-3526.

Sharenda L, Burton E. Disseminated toxoplasmosis in a patient with undiagnosed AIDS. Baylor University Medical Center Proceedings 2009;22(1):20-22.

Herold MA, Kühne R, Vosberg M, Ostheeren S, Vogt P; Karrer U. Disseminated toxoplasmosis in a patient with non-Hodgkin lymphoma. Infection. 2009;37:551-554. http://dx.doi.org/10.1007/s15010-009-9007-5

Dupont, CD. Christian DA, Hunter CA. Immune response and immunopathology during toxoplasmosis. Seminars in Immunopathologyl. 2012;34(6):793-813. http://dx.doi.org/10.1007/s00281-012-0339-3

Lappalainen M, Jokiranta S, Halme L, et al. Disseminated toxoplasmosis after liver transplantation: Case report and review. Clinical Infectious Diseases. 1998;27:13278 http://dx.doi.org/10.1136/jcp.55.8.637

Cabre P, Smadja D, Cabie A, Newton CR. HTLV-1 and HIV infections of the Central Nervous system in tropical areas. Jornual Neurology Neurosurgery Psychiatry. 2000;68:550-557. http:/dx.doi.org/10.1136/jnnp.68.5.550

Gómez JE, Gómez JE, Alvarado F, Hernández C, Cuervo S, Saravia J. Tratamiento de la fase aguda de la toxoplasmosis cerebral con Clindamicina - Falcidar (pirimetamina-sulfadoxina) en pacientes infectados por VIH. Infection. 2001;5(3):163-169.

Abgrall S, Rabaud C, Costagliola D. Incidence and risk factors for toxoplasmic encephalitis in human immunodeficiency virus-infected patients before and during the highly active antiretroviral therapy era. Clinical Infectious Diseases. 2001;33:1747-55.

Machala L, Malý M, Hrdá S, Rozsypal H, M, Kodym P. Antibody response of HIV-infected patients to latent, cerebral and recently acquired toxoplasmosis. European Journal of Clinical Microbiology & Infectious Diseases. 2009;28:179-182. http://dx.doi.org/10.1007/s10096-008-0600-9

Palella FJ, Delaney KM, Moorman AC, et al. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. The New England Journal of Medicine.1998;338:853-860. http://dx.doi.org/ 10.1056/NEJM199803263381301.

Varughese JK, Rosenberg MG, kim K. HIV in the tropics: staging in the resource-limited setting. Current Opinion in Infectious Diseases. 2012;25:477-483. http://dx.doi.org/10.1097/QCO.0b013e3283567b00.

Leport C, Chene T, Morlat P, et al. Pyrimethamine for primary prophylaxis of toxoplasmic encephalitis in patients with human immunodeficiency virus infection: a double-blind, randomized trial. The Journal of Infectious Diseases. 1996;173:91-7.

Signorini L, Gulletta M, Coppini D, et al. Fatal disseminated toxoplasmosis during primary HIV infection. Current HIV Research. 2007;5:273-274. http://dx.doi.org/10.2174/157016207780077011

Eza DE, Lucas SB. Fulminant toxoplasmosis causing fatal pneumonitis and myocarditis. HIV Medicine. 2006; 7:415-420. http://dx.doi.org/ 10.1111/j.1468-1293.2006.00393.x

Tirard V, Niel G, Rosenheim M, et al. Diagnosis of toxoplasmosis in patients with AIDS by isolation of the parasite from the blood. The New England Journal of Medicine. 1991;324:632.

Belanger F, Derouin F, Grangeot K, Meyer L. and the HEMOCO and SEROCO Study Groups. Incidence and risk factors of toxoplasmosis in a cohort of human immunodeficiency virus-infected patients: 1988-1995. Clinical Infectious Diseases.1999;28(3):575-581. http://dx.doi.org/10.1086/515147.

Rabaud C, May T, Amiel C, et al. Extracerebral toxoplasmosis in patients infected with HIV. A French National Survey. Medicine.1994;73(6):306-314.

Kovari H, Ebnöther C, Schweiger A, Berther N, Kuster H, Gunthard HF. Pulmonary toxoplasmosis, a rare but severemanifestation of a common opportunistic infection in late HIV presenters: Report oftwo cases. Infection. 2010;38:141-144. http://dx.doi.org/10.1007/s15010-009-9367-5

Ganji M, Tan A, Maitar MI, Weldon CM, Weisenberg E, Rodano DP. Gastric toxoplasmosis in a patient with Acquired Immunodeficiency Syndrome. A case report and review of the literature. Archives of Pathology & Laboratory Medicine. 2003;127:732-734.

Seguro FS, Assis RA, Silveira PA, Bezerra AM. Images in haematology. Toxoplasma gondii in the bone marrow after pancreas-kidney transplantation. British Journal of Haematology. 2009;147(3):276. http://dx.doi.org/10.1111/j.1365-2141.2009.07680.x.

Most read articles by the same author(s)

OJS System - Metabiblioteca |