Guerrero-Flores A, Vega-Ramos B

Language: Spanish
References: 12
Page: 37-41
PDF size: 57.10 Kb.

ABSTRACT

Introduction. Toxoplasma gondii is an intracellular parasite which has been identified as an opportunistic pathogen in immunodeficienty people. During the present aids era the number of clinical cases of toxoplasmosis has incresead. The majority are associated with central nervous system infections and very few have been published regarding gastrointestinal manifestations. The few cases described report severe abdominal pain, nausea and vomiting. Revista Biomédica Case presentation. Male, 34 years old, carrier HIV. He came to emergency room with fever of six months, anorexia, disphagia and epigastric pain. By endoscopy candidiasis was observed in the esophagus with ulcers in distal portion suggesting CMV. IgG CMV and toxoplasma antibodies were positives, anemia 8 g/dL, lymphocytes T CD4 28/µL, viral load PCR HIV amplicor 195,574 cop/mL. Then received treatment for 3 weeks with ganciclovir I.V. and fluoconazole. Anti retroviral treatment was interrupted after symptomatic gastric intoleranc e. TMP/SMX and pyrimetamine were also administred. It was thought that the cause was gastritis medication and or reactivation of the ulcers by CMV. New endoscopy with a biopsy of the gastric mucous showed an acute gastritis secondary to the toxoplasma. Patient quit coming to appointments and died two months later at his home with wasting syndrome. Discussion. These cases are usually accompanied by a notable immunodepression of linfocytes CD4 and strong digestive symptoms which are attributed to various causes. This is the first case that trofozoitos of T. gondii have been identified in the gastric mucous of an aids patients in the Yucatan Peninsula, and therefore we should consider testing AIDS patients with linfocytes CD4 ‹ 50/ µL, and symptoms such as anorexia, nausea, vomiting, abdominal pain, fever and diarrhea for T. gondii

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