Toxoplasmosis humana generalizada

Abstract

A third case of fatal human toxoplasmosis is reported for Costa Rica, in a 10-year-old girl from the rural area in the same geographical zone as the other two cases. The clinical picture presented an initial indeterminate infectious stale, later becoming located in the respiratory organs. During the final period there were signs of moderate cardiac insufficiency, and a skin eruption resembling measles. The etiologic diagnosis was not made during the clinical study, and the antibiotic and chemotherapeutic treatment, intended to combat an infectious state of unknown etiology, was unsuccessful. The process developed in pure form, i.e., no other disease contributed. to the fatal outcome. The pulmonary picture is that of a desquamative broncho-alveolitis with abundant formation of giant multinucleate cells; in some alveoli macrophages with parasites were found. In the cerebral cortex, optic thalamus, and spinal cord, inflammatory foci were found, some associated with pseudocysts containing abundant toxoplasms. Focal lesions of necrotic aspect were found in the hypophysis with moderate inflammatory cellular infiltration and interstitial edema; macrophages full of parasites were also found here. The myocardium showed interstitial edema, diffuse focal infiltration of mononuclear elements, and groups of parasites within some fibers. The spleen presented hyperplasia of the white pulp; some macrophages containing parasites were identified. In the adrenal glands, inflammatory foci were found in both the cortex and the medulla, as well as some necrobiotic areas; he re also the identification of some macrohages with phagocyted parasites was possible. The thyroid showed a bypofunctional morphologic aspect.