Document 3220
 DOCN  M94A3220
 TI    Evaluation of cell culture in the diagnosis of cerebral and pulmonary
       toxoplasmosis.
 DT    9412
 AU    Contini C; Magno S; Romani R; Zenobi P; Angelici E; Cultrera R; Delia S;
       Inst Infect and Resp Dis. University of Ferrara, Italy.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):126 (abstract no. PA0125). Unique
       Identifier : AIDSLINE ICA10/94369355
 AB    OBJECTIVE: To evaluate T. gondii in blood, lung secretions [BAL], and
       cerebrospinal fluid specimens [CSF] obtained from AIDS patients with
       proven or suspected toxoplasmosis. METHODS: Samples were obtained from
       12 AIDS patients (8 men, 4 women, age range 26-34 years, CD4+ cell
       counts < 50/10(6)/ml) hospitalized between December 1993 and February
       1994. Separated blood mononuclear cells [PBMC], BAL cell pellets and
       non-concentrated CSF fluids were inoculated in MRC5 tissue cultures and
       T. gondii was investigated after 12 h of culture with indirect
       immunofluorescence. RESULTS: Isolation of T. gondii was made in 10
       (83.3%) patients. Of these, four were on prophylaxis against
       toxoplasmosis because of a past cerebral toxoplasmosis documented by
       clinical features, CT-scan abnormalities, significant serology for
       toxoplasma and positive response to anti-toxoplasma treatment; three had
       respiratory disorders indicative of interstitial pneumonia, CT-scan
       lesions not suggestive of brain toxoplasmic involvement, positive
       serology for T. gondii (2 cases), which successfully responded to
       anti-toxoplasma therapy. In these 7 patients, T. gondii organisms were
       demonstrated in blood (6 cases), BAL (2 cases) and CSF (6 cases). In all
       treated patients, cultures became negative or parasites were
       morphologically abnormal. All samples tested underwent routine
       cytological examination for Pneumocystis, Mycobacteria and fungi which
       scored negative. In two cases (33.3%), BAL samples also detected
       Cytomegalovirus. The other 3 patients had mild neurologic disorders
       associated to toxoplasmic parasitemia in more blood samples.
       CONCLUSIONS: The results obtained seem to argue: i) diagnosis by tissue
       culture substantiates previous observations which indicate this method
       sensitive and specific to provide evidence of infection; ii) tissue
       culture allows diagnosis in cases with only pulmonary symptoms thus
       suggesting a primary lung localization or disseminated toxoplasmosis;
       iii) the isolated parasitemia should be properly evaluated since its
       presence may correlate with the occurrence of clinical disease.
 DE    Adult  Animal  AIDS-Related Opportunistic Infections/BLOOD/CEREBROSPINAL
       FLUID/  *DIAGNOSIS  Brain/RADIOGRAPHY  Female  Human  Lung Diseases,
       Parasitic/BLOOD/CEREBROSPINAL FLUID/*DIAGNOSIS  Lymphocytes/PARASITOLOGY
       Male  Tissue Culture/*METHODS  Tomography, X-Ray Computed
       Toxoplasma/*ISOLATION & PURIF  Toxoplasmosis/BLOOD/CEREBROSPINAL
       FLUID/*DIAGNOSIS  Toxoplasmosis, Cerebral/BLOOD/CEREBROSPINAL
       FLUID/*DIAGNOSIS  MEETING ABSTRACT

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