Toxoplasmic Myocarditis and Polymyositis in Patients with Acute Acquired Toxoplasmosis Diagnosed During Life

Abstract

The presence of both toxoplasmic myocarditis and myositis in the same individual has been reported only at autopsy. We report the first case of biopsy-proven toxoplasmic myocarditis and polymyositis simultaneously occurring in the same individual that was diagnosed during life. Results of her toxoplasmic serology were consistent with acute toxoplasmosis. She subsequently developed visual symptoms consistent with toxoplasmic chorioretinitis. She had a positive clinical response to therapeutic agents specific against Toxoplasma gondii. Her toxoplasmic serological profile established the diagnosis of acute toxoplasmosis. A toxoplasmic serological profile should be obtained for patients with myocarditis and/or polymyositis of unclear etiology. Endomyocardial or skeletal muscle tissue biopsies may establish the definitive diagnosis of toxoplasmic myocarditis or polymyositis, respectively. Examination of blood by polymerase chain reaction analysis before antitoxoplasmic treatment and early in the course of primary infection with T. gondii may prove useful.

Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon

“…The lesions reported in our case are classified as severe and are mostly caused by T. gondii serotype I, which is less sensitive to therapy with Pyrimethamin in vitro 3,20,33 . Musculoskeletal involvement concomitant to T. gondii infection in immunocompetent patients is described as a proximal and symmetrical myositis [29][30][31] ; in contrast to the focal and asymmetrical involvement (right thigh) reported hereby. Although trauma is a frequent cause of avascular necrosis, the antiangiogenic state triggered by T. gondii impairs healing and is an aggravating factor for this condition 21,38 .…”

“…Slow and partial recovery from right hip articulation disability can also be explained by axonolysis, and an altered immune response 38 . Relapses have been reported even after receiving first line antiprotozoal treatment, because it does not eliminate bradyzoites and in other cases because of long corticosteroid therapy 29 .…”

Seroprevalence for toxoplasmosis in individuals living in North West Tuscany: access to Toxo-test in central Italy

“…Infection with T. gondii has been recognised as a problem in immunocompetent adults, as well as in immunocompromised individuals [7][8][9][10][11][12].…”

ICU acquired weakness or something else?

“…However, extremely rare cases of pneumonitis, ARDS, myocarditis, pericarditis, polymyositis, hepatitis and encephalitis have been reported. [13][14][15] This case presented as a rare case of Toxoplasmosis with involvement of muscle, CNS and respiratory system.…”