Fatal Toxoplasma Myocarditis in an Adult Patient with Acute Lymphocytic Leukemia

Wertlake, Paul T.; Winter, Thorne S.

doi:10.1056/nejm196508192730808

Cited by 39 publications

(6 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The prevalence of Toxoplasma myocarditis in AIDS autopsies varies from < 1 to 12% [19,20]. There are a few reports of severe Toxoplasma myocarditis occurring in isolation, but a fatal outcome has been described in only a limited number of cases [15,16,21], in the absence of an associated encephalitis [13,14,20]. As acute Toxoplasma infections are usually disseminated, isolated myocarditis probably reflects localized parasite reactivation [13,20].…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, in the absence of encephalitic symptoms, toxoplasmosis may not be included in the differential diagnosis. There are few reports of fulminant toxoplasmic myocarditis resulting in death [13–16]. Toxoplasmic pneumonitis is responsible for less than 1% of HIV‐related pulmonary complications [17], and can occasionally cause fatal septic shock, generally associated with adult respiratory distress syndrome (ARDS) [18].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Fulminant toxoplasmosis causing fatal pneumonitis and myocarditis

Eza

Lucas

2006

HIV Medicine

View full text Add to dashboard Cite

The obligate intracellular protozoa Toxoplasma gondii is a serious cause of morbidity and mortality in patients with AIDS. Toxoplasmosis most frequently manifests as life‐threatening encephalitis, although extracerebral sites may be involved with or without toxoplasmic encephalitis. Consequently, toxoplasmosis can present in an unusual manner, and may not be included in the differential diagnosis in the absence of encephalitic symptoms. There are few reports of fulminant toxoplasmic myocarditis resulting in death. Toxoplasmic pneumonitis is responsible for less than 1% of HIV‐related pulmonary complications, and can occasionally cause fatal septic shock. Two such clinicopathological presentations of toxoplasmosis are reported here. One patient presented with cardiorespiratory signs and symptoms, whilst the second patient presented with pneumonitis and renal failure. Neither patient was initially known to be HIV‐infected, nor did they have clinical symptoms indicating toxoplasmic encephalitis. Toxoplasmosis was only diagnosed on autopsy and had resulted in death by causing a fulminant myocarditis and a pneumonitis. As overwhelming toxoplasmosis infection may prove rapidly fatal, these two case reports serve as a clinical reminder to consider toxoplasmosis in the differential diagnosis of HIV‐infected patients who present with severe cardiorespiratory signs and symptoms. Furthermore, the cases emphasize the potential importance of early tissue biopsy in patients presenting with immunosuppression‐associated organ failure, and show the importance of requesting a postmortem examination if the cause of death cannot be ascertained in vivo.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fulminant toxoplasmosis causing fatal pneumonitis and myocarditis

Eza

Lucas

2006

HIV Medicine

View full text Add to dashboard Cite

show abstract

“…Toxoplasma can exist in the muscle tissues in a cyst form where it evokes a tissue response, whereas ruptured cysts w ill evoke an inflammatory response [17], M ohr and Honig [7] have shown experimentally in in oculated hamsters that animals with ECG changes had typical myocarditis, whereas those without ECG changes had toxoplasma organism in pseudo cysts surrounded by intact myocardium. These may be some of the reasons why some members of the families had ECG changes with negative serology and vice versa.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Toxoplasmosis in Ceylon

Nagaratnam¹,

Siripala²

1970

Cardiology

View full text Add to dashboard Cite

A study of siblings of three patients with myocardial toxoplasmosis suggests a significant degree of familial incidence. The diagnosis was based on the results of the hemagglutination test for toxoplasmosis and on the presence of electrocardiographic changes. In all cases the clinical involvement was predominantly myocardial, suggesting that Toxoplasma gondii as Trypanosoma cruzi, could be primarily cardiotropic.

show abstract

“…En estos pacientes los síntomas más frecuentes han sido de fiebre de origen desconocido, desorientación, miocarditis, neumonía intersticial y fiebre que no responde a antibióticos (27,28,29,30,31,32).…”

Section: Discusionunclassified

“…Sólo uno de nuestros pacientes falleció; él presentó un cuadro severo de dificultad respiratoria del adulto, asociado a miocarditis; al respecto, la miocarditis por Toxoplasma gondii, ha sido descrita como seria y fatal (27,32). Los otros cuatro pacientes afectados por toxoplasmosis sobrevivieron, dos de ellos cumplieron tratamiento antitoxoplasma con una buena evolución.…”

Section: Discusionunclassified

Toxoplasmosis en Bartonellosis humana.

Maguiña¹,

Gotuzzo²,

Alvarez³

et al. 2013

Rev Med Hered

View full text Add to dashboard Cite

RESUMEN:Objetivo: Estudiar la complicación oportunista producida por la toxoplasmosis en pacientes con Bartonellosis en la fase aguda hemática. Material y Métodos: Estudio prospectivo realizado en 68 pacientes de la fase febril anemizante de la Bartonellosis humana atendidos en el Hospital Nacional Cayetano Heredia. Como criterios de la complicación infecciosa por toxoplasmosis se uso el cuadro clínico ( fiebre de origen desconocido, linfoadenomegalia, etc.) presencia de títulos Ig M positivos (Elisa, IFI) y títulos de Ig G altos (>1/1024 o un incremento más de 4 veces del valor basal) y la presencia en biopsias de taquizoitos de Toxoplasma gondii. Resultados: De 68 pacientes con Bartonellosis en 25 (36.7%) presentaron algunas complicaciones infecciosas, de ellos 5/25 (20%) fueron debidas a toxoplasmosis reactivada. El cuadro clínico sistémico de la toxoplasmosis se caracterizó por presencia de fiebre en 5/5, lesión hepática en 3/5, insuficiencia respiratoria en 3/5 y lesión miocardica en 2/5, 3 pacientes fueron tratados a base de pririmetamina más clindamicina o cotrimoxazol habiendo recuperación completa en 2 de ellos y uno fallecido con miocarditis por Toxoplasma gondii, 2 pacientes no recibieron tratamiento específico y la enfermedad se autolimitó sola; 4/5 tuvieron incrementos significativos de títulos (IFI) > 4 veces del valor basal ( rango: 4-250 veces); 3/5 tuvieron titulo + IgM (Elisa, IFI) y en 2/5 se detectó mediante biopsia la presencia del Toxoplasma gondii en el tejido pulmonar y miocárdico. Conclusión: Destacamos en forma importante la complicación oportunista de toxoplasmosis reactivada en pacientes con bartonellosis durante la fase aguda hemática. ( Rev Med Hered 1998; 9:14-20).

show abstract

Fatal Toxoplasma Myocarditis in an Adult Patient with Acute Lymphocytic Leukemia

Cited by 39 publications

References 10 publications

Fulminant toxoplasmosis causing fatal pneumonitis and myocarditis

Fulminant toxoplasmosis causing fatal pneumonitis and myocarditis

Myocardial Toxoplasmosis in Ceylon

Toxoplasmosis en Bartonellosis humana.

Contact Info

Product

Resources

About