1/22. Demonstration of parasites in toxoplasma lymphadenitis by fine-needle aspiration cytology: report of two cases.Two cases of toxoplasma lymphadenitis diagnosed by fine-needle aspiration (FNA) cytology, in which the microorganisms were identified in the cytologic preparations, are presented. The first case was that of an 8-yr-old boy with bilateral cervical lymphadenopathy of 2-mo duration, in which an FNA specimen of one of the lymph nodes in a Papanicolaou-stained smear disclosed a toxoplasma cyst, and in Wright-Giemsa preparation, dispersed tachyzoites and a pseudocyst. The second case was that of a 52-yr-old man with enlargement of a single lymph node in the neck, of 3-mo duration, FNA of which in Wright-Giemsa preparation disclosed numerous tachyzoites dispersed free in exudate, and also within cells, forming pseudocysts. In both cases, immunocytochemistry by the peroxidase method for toxoplasma gondii antigen was positive. The tachyzoites seen in Wright-Giemsa preparations, when subjected to fluorescence microscopy, emitted autofluorescence, facilitating their identification. While the presence of parasites in toxoplasma lymphadenitis is quite unusual, having been reported occasionally in histologic preparations and only rarely in cytologic FNA materials, our 2 cases suggest that in active disease, tachyzoites may not be so uncommon in FNA specimens. Besides the use of immunocytochemistry in the diagnosis of the disease, air-dried preparations stained by the Wright-Giemsa method are valuable for the demonstration of such parasites through careful search, along with the possible use of fluorescence microscopy.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/22. Congestive heart failure and myocarditis after seroconversion for toxoplasmosis in two immunocompetent patients.Two cases of myocarditis and congestive heart failure in immunocompetent patients with seroconversion for toxoplasmosis are reported. Serological tests showed that in the first case the cardiac manifestations occurred at the time of seroconversion (low IgG, raised IgM and IgA), whereas in the second case they occurred several months after the initial infection when IgM was decreasing, IgG levels were very high (>1000 IU/ml) and IgG had high affinity for the antigen. The pathophysiological mechanisms underlying cardiac involvement in acute or chronic toxoplasmosis are discussed.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/22. 1: Infections in pregnant women.Some infections are more serious in pregnant than non-pregnant women because of the potential for vertical transmission to the fetus or infant (eg, varicella, rubella, cytomegalovirus infection, toxoplasmosis and listeriosis). Pre-pregnancy or routine antenatal screening for presence of, or susceptibility to, some of these infections and appropriate management can prevent adverse fetal or perinatal outcomes; screening should include rubella IgG, hepatitis b surface antigen, serological tests for syphilis and HIV antibody. If certain other vertically transmissible infections are suspected because of a positive antenatal test result, confirmatory tests for maternal and, if indicated, fetal infection are essential before intervention is considered (eg, cytomegalovirus infection). For some vertically transmissible infections that are not readily preventable, appropriate management of maternal infection can reduce fetal damage (eg, toxoplasmosis).- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/22. toxoplasma encephalitis in HIV: case report.In tanzania, no data are available on the prevalence of brain infection by toxoplasma in HIV-infected patients. A case of a 35-year old man with fulminant toxoplasma encephalitis (TE) is reported for the first time. TE was not suspected clinically in our patient who presented with a one week history of severe headache and treated empirically with antimalarial drugs. TE was diagnosed postmortem histologically by haematoxylin-eosin and immunohistochemical stain with P30 antibody for toxoplasma antigen. The findings in our case support the suggestion that a high index of suspicion for TE should be maintained in HIV-infected patients presenting with focal neurological symptoms. The case highlights the importance of autopsy studies in not only documenting a toxoplasma brain lesion but also in increasing the awareness for its diagnosis in HIV-infected patients in tanzania and other developing countries.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/22. Skeletal muscle toxoplasmosis in patients with acquired immunodeficiency syndrome: a clinical and pathological study.The present article describes the clinical and pathological findings in 5 human immunodeficiency virus (HIV)-infected patients with muscle toxoplasmosis. The patients had marked lymphopenia (5/5), with less than five CD4 cells/mm3 (3/3), when they developed fever (5/5), and multiorgan failure (5/5), including diffuse encephalitis, pneumonia, pancytopenia, and myopathy. Muscle involvement included weakness and wasting (4/5), myalgias (3/5), and high serum creatine kinase levels (3/3). serology for toxoplasmosis showed high IgG titers in 3 patients (3/4). Anti-toxoplasma therapy resulted in complete recovery in 2 patients. Muscle toxoplasmosis was detected by biopsy (3/5) or postmortem evaluation (2/5), and was identified using immunocytochemistry and electron microscopy. toxoplasma cysts were detected in 0.5 to 4% of muscle fibers close to or remote from necrotic fibers and inflammatory infiltrates. Muscle fibers strongly expressed the major histocompatibility complex class I antigen (2/2) as in polymyositis. We suggest that toxoplasma gondii should be sought by muscle biopsy in patients who have acquired immunodeficiency syndrome with fever, encephalitis, multiorgan dysfunction, and elevated serum creatine kinase levels of obscure origin.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/22. A novel mutation for TAP deficiency and its possible association with toxoplasmosis.We describe two siblings (a male patient and his older sister) with a novel mutation in the peptide transporter associated to antigen processing (TAP). The index case presented with not only granulomatous skin lesions and recurrent sino-pulmonary infections, often associated with this deficiency, but also a severe pulmonary toxoplasmosis. His toxoplasmosis and skin lesions were successfully treated.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/22. Multifocal multinucleated giant cell myelitis in an AIDS patient.A 19-year-old male intravenous drug abuser, was admitted to hospital with a one-week history of lower limb weakness and urinary retention. He was known to have been HIV-seropositive for 3 years and had been treated for cerebral toxoplasmosis. Neurological examination confirmed flaccid paraparesis with weak ankle jerks and bilateral extensor plantar responses. There was no obvious sensory deficit. Neurological examination was otherwise normal. CSF contained 63 mg/dl protein and 10 leucocytes/mm3. myelography was normal. He died 1 month later from septic peritonitis. Neuropathological examination showed chronic lesions of toxoplasmosis in brain. Small necrotic foci with myelin loss, proliferation of microglia, macrophages and multinucleated giant cells (MGC) were disseminated in the whole spinal cord, mostly in the white matter, but the brain was spared. immunohistochemistry demonstrated p24 and p17 hiv antigens in macrophages, MGC and microglial cells. These lesions resemble those of so called 'multifocal giant cell encephalitis'. The present case demonstrates that HIV-related multifocal inflammatory changes may be restricted to the spinal cord and may be a cause of myelopathy in AIDS patients.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/22. Identification of toxoplasma gondii infections by BI gene amplification.The diagnosis of toxoplasmosis in congenitally infected children or in immunocompromised patients can be difficult; serology is not reliable, and the diagnosis must be based on the combination of symptomatology and the direct demonstration of the parasite in clinical specimens by microscopy, antigen detection, or inoculation of samples into mice or tissue cultures. These techniques are either insensitive or time-consuming. To determine the value of the polymerase chain reaction (PCR) for the diagnosis of toxoplasma gondii infections, we compared this technique with conventional detection techniques, such as microscopy, tissue culturing, and mouse inoculation. We were able to detect T. gondii by PCR in clinical specimens and tissue samples that were obtained postmortem from a bone marrow recipient with cerebral toxoplasmosis and from three congenitally infected children. The presence of T. gondii was demonstrated in brain tissue, cerebrospinal fluid, the heart, and skeletal muscle tested fresh or after fixation in Formalin. In only one sample was T. gondii isolated by mouse inoculation but not detected by PCR. Because it is a sensitive, relatively rapid, and specific method and because it can be applied to a variety of different clinical samples, PCR can be considered a valuable additional tool for the identification of T. gondii infections.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/22. Acute toxoplasma myositis: an immunohistochemical and ultrastructural study.The occurrence is reported of acute myositis in a man with meningoencephalitis due to toxoplasmosis. The ultrastructure and immunohistochemistry of a muscle biopsy of the patient were investigated. toxoplasma organisms were not found in the muscle biopsy. The perivascular inflammatory cells in the muscle were mainly CD4 T cells and the inflammatory cells in and around the muscle fibres were chiefly macrophages. Expression of major histocompatibility complex class I and II antigens was observed in the infiltrating cells and endothelial cells of the blood vessels. A small proportion of the infiltrating cells expressed interferon-gamma. A possible role of the immune mechanism in the evolution of myositis is discussed.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/22. B-cell nature malignant lymphoma probably caused by EB-virus infection.In cells in a haemopericardium associated with a B-cell malignant lymphoma, immature herpes type virus particles were found by electron microscopy. Epstein-Barr virus associated nuclear antigen (EBNA) and virus capsid antigen (VCA) were also found, both in the tumor cells, in the bloody pericardial fluid and in cultivated cells. Serological studies revealed high anti-toxoplasma antibody levels both in the pericardial fluid and in serum. Both EB virus and toxoplasma infections are assumed to have played an important role on the pathogenesis of the present case.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
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