Document 0635
 DOCN  M9440635
 TI    Extracerebral toxoplasmosis in the acquired immunodeficiency syndrome
       (AIDS).
 DT    9404
 AU    Hofman P; Bernard E; Michiels JF; Thyss A; Le Fichoux Y; Loubiere R;
       Service d'Anatomopathologie, Universite de Nice, France.
 SO    Pathol Res Pract. 1993 Sep;189(8):894-901. Unique Identifier : AIDSLINE
       MED/94134552
 AB    Although Toxoplasma gondii frequently causes lesions of the central
       nervous system in AIDS, the exact incidence of extracerebral
       toxoplasmosis in these immunodepressed patients remains difficult to
       determine. Isolation of the parasite outside the central nervous system
       is rarely performed ante mortem, and most diagnoses of extracerebral
       toxoplasmosis are made post mortem. This article describes 23 cases of
       extracerebral toxoplasmosis diagnosed between 1987 and 1991 in an
       autopsy series of 170 patients infected with the human immunodeficiency
       virus (HIV). Ante mortem diagnosis of extracerebral involvement was
       affirmed in 4 of these 23 patients by identification of trophozoites in
       bronchoalveolar lavage fluid (2 cases), a surgical pulmonary biopsy
       specimen, and a bladder biopsy. Clinical and paraclinical findings
       suggested cardiac involvement in 4 other patients. Post mortem
       examination demonstrated disseminated toxoplasmosis in 18 cases and
       extracerebral monovisceral involvement in 5 cases. Extracerebral
       toxoplasmosis was directly responsible for the death of 6 patients. The
       most frequent extracerebral sites of Toxoplasma gondii involvement were
       the heart (21/23 cases; 91%), the lungs (14/23 cases; 61%) and the
       pancreas (6/23 cases; 26%). The tissular consequences of toxoplasmic
       involvement varied considerably, from formation of pseudocysts or cysts
       without any surrounding inflammatory reaction to necrotic lesions rich
       in neutrophilic polynuclear cells containing numerous free parasites.
       Immunoperoxidase study using antitoxoplasmic antibodies contributed to
       the diagnosis of 8 extracerebral localizations. Electron microscopy
       examination of a surgical lung biopsy and myocardial specimens (2 cases)
       demonstrated the ultrastructural characteristics of Toxoplasma gondii
       trophozoites.(ABSTRACT TRUNCATED AT 250 WORDS)
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS/EPIDEMIOLOGY/
       PATHOLOGY  Adult  Aged  Aged, 80 and over  Animal  Autopsy
       Bladder/PATHOLOGY/PARASITOLOGY/ULTRASTRUCTURE  Female
       Heart/PARASITOLOGY  Human  Immunoenzyme Techniques
       Lung/PATHOLOGY/PARASITOLOGY/ULTRASTRUCTURE  Male  Microscopy, Electron
       Middle Age  Myocardium/PATHOLOGY/ULTRASTRUCTURE
       Pancreas/PATHOLOGY/PARASITOLOGY/ULTRASTRUCTURE  Retrospective Studies
       Toxoplasma/ISOLATION & PURIF
       Toxoplasmosis/*COMPLICATIONS/EPIDEMIOLOGY/PATHOLOGY  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).