Successful Treatment of Pulmonary and Cerebral Toxoplasmosis Associated with Pneumocystis Pneumonia in an HIV Patient
by
Marie-Françoise Rey 1, Charles Mary 2, Diane Sanguinetti 2
, Stéphane Ranque 2, Christophe Bartoli 1 and Coralie L’Ollivier 2,*
Marie-Françoise Rey 1, Charles Mary 2, Diane Sanguinetti 2, Stéphane Ranque 2, Christophe Bartoli 1 and Coralie L’Ollivier 2,*
1
Department of Interregional Secure Hospital, AP-HM, University Hospital, 13915 Marseille CEDEX, France
2
Université Aix Marseille, CNRS 7278, IRD 198, Inserm 1095, AP-HM, URMITE, IHU Méditerranée Infection, 13915 Marseille CEDEX, France
*
Author to whom correspondence should be addressed.
Diseases 2017, 5(4), 35; https://doi.org/10.3390/diseases5040035
Received: 21 November 2017 / Revised: 13 December 2017 / Accepted: 14 December 2017 / Published: 18 December 2017
(This article belongs to the Section Infectious Disease)
In both the post and pre combination antiretroviral therapy (cART) era, Pneumocystis jirovecii and Toxoplasma gondii remain common opportunistic infectious agents. The common manifestations are pneumonia for P. jirovecii and brain abscess for T. gondii. Nevertheless, co-infection remains rare, and pulmonary toxoplasmosis is scarce, or may be underestimated because of its similarity with Pneumocystis jirovecii pneumonia. We reported an uncommon case of an AIDS patient (6 CD4 + T cells/mm3) with both pulmonary and cerebral toxoplasmosis associated with pneumocystis pneumonia. The patient presented with general weakness, fever and dyspnea. Pulmonary toxoplasmosis and pneumocystis were confirmed by microscopic examination and DNA detection in the bronchoalveolar lavage. Computed tomography imaging of the brain revealed a single characteristic cerebral toxoplasmosis lesion of the left capsular area. He was successful treated by trimethoprim/sulfamethoxaxole in conjunction with an early reintroduction of cART, and without IRIS development. During a 3-year follow-up, HIV viral load remained undetectable, and the patient did not relapse for toxoplasmosis or Pneumocystis pneumonia.
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Keywords:
Pneumocystis jirovecii; Toxoplasma gondii; pneumonia; cerebral; trimethoprim/sulfamethoxaxole
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MDPI and ACS Style
Rey, M.-F.; Mary, C.; Sanguinetti, D.; Ranque, S.; Bartoli, C.; L’Ollivier, C. Successful Treatment of Pulmonary and Cerebral Toxoplasmosis Associated with Pneumocystis Pneumonia in an HIV Patient. Diseases 2017, 5, 35.
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