Resumo

MAGUINA, Ciro et al. Toxoplasmosis in Human Bartonela disease. Rev Med Hered [online]. 1998, vol.9, n.1, pp.14-20. ISSN 1018-130X.

Objective: To study opportunistic complications produced by toxoplasmosis in patients with the acute hematic stage of Bartonellosis. Material and Methods: Prospective study performed in 68 patients with the febrile anemic stage of human Bartonellosis, seen at he Hospital Nacional Cayetano Heredia. Criteria for the diagnosis were clinical picture with fever of obscure origin, lymphoadenomegaly, etc, significant IgM antitoxoplasma titers (ELISA, IFI), high IgG titers ( >1/1024 or 4-fold increase over the basal tier) and presence of Toxoplasma gondii tachyzoitos in biopsies. Results: Infectious complications were seen in 25 (37.5%) patients;5 of them were due to reactivated toxoplasmosis. The systemic clinical picture was characterized by fever in 5/5, hepatic lesion in 3/5, respiratory insufficiency in 3/5, myocardial lesion in 2/5. Diagnoses were supported by significant titer increases (4 to 250-fold) in 4/5 patients; 3/5 had high IgM titters ( Elisa and IFI) and in 2/5 T. gondii was found in lung and myocardial biopsies. Three patients were treated with pyrimethamine plus clindamycxin or cotrimoxazole; two recovered completely and one died with myocarditis due to T. gondii. The two other patients received no specific antitoxoplasma treatment, and their disease was self-limited. Conclusion: The present communication establishes toxoplasmosis as an important opportunistic infection of patients in the anemic stage oh human bartonellosis. ( Rev Med Hered 1998; 9:14-20 ).

Palavras-chave : Bartonellosis; Toxoplasmosis reactivation.

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