The Authors report clinical and epidemiological features of three rare cases of Toxoplasma gondii pneumonia in patients infected with H1V.
Toxoplasma gondii has been recognized as pathogen in immunocompromised patients for more than twenty years (10). Cerebral toxoplasmosis has been reported to occur in 10-15% of patients with AIDS and is the presenting diagnosis in 5% (3, 5). Patients with AIDS only rarely have involvement of extra-CNS sites (2, 4, 11). This is in sharp contrast with immunocompromised patients without AIDS in whom extra-CNS organ involvement occurres often (10). Pulmonary toxoplasmosis has been reported in few patients with HIV infection (2, 4, 8, 9, 11). In a series of 441 AIDS patients with pneumonia 0nly one presented toxoplasmosis (7).
We report three rare cases of Toxoplasma gondii pneumonia in AIDS patients. Case one: a 26-year-old woman, drug-addict, HIV positive (by ELISA and Western Blot analysis), was admitted to our Department with one month history of fever (39 Β° C), asthenia, dyspnea, weight-loss, oral candidiasis and scotoma of left eye. The chest x-ray film showed a bilateral and diffuse interstitial infiltrate. Cultures of sputum and Pneumocystis carinii detection were negative. Fibreoptic bronchoscopy with transbronchial biopsy revealed tachizoites of Toxoplasma gondii (Giemsa and Gomori-Grocott staining). Microscopy of the lung showed fibrinous exudate, necrosis areas with intra and extracellular tachizoites along the Corresponding author.