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Pulmonary Toxoplasmosis Diagnosed on Transbronchial Lung Biopsy in a Mechanically Ventilated Patient

机译:诊断为机械通风患者跨界肺活检的肺弓形病

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Toxoplasma gondii is a protozoan parasite that infects up to a third of the world’s population. Infection is mainly acquired by ingestion of food or water that is contaminated with oocysts shed by cats or consuming undercooked meat containing tissue cysts. Primary infection is subclinical in immunocompetent hosts. Invasive toxoplasmosis often manifests as cerebral toxoplasmosis in immunosuppressed patients. In persons living with human immunodeficiency virus (HIV), toxoplasmosis occurs when CD4 counts are very low and is considered an acquired immunodeficiency syndrome (AIDS) defining illness. Pulmonary toxoplasmosis is rarely seen in the highly active antiretroviral therapy era. The diagnosis can be challenging due to the nonspecific nature of clinical and radiographic findings. In this report, we present a case of pulmonary toxoplasmosis in a new onset AIDS patient, which was initially clinically misdiagnosed as Pneumocystis jiroveci pneumonia (PJP). Due to a poor response to treatment for PJP, the patient underwent a transbronchial lung biopsy, which led to the diagnosis of pulmonary toxoplasmosis.
机译:弓形虫是一种原生动物寄生虫,可感染世界上三分之一的人口。感染主要是通过摄入食物或水被污染的食物或水污染,这些食物或水被猫抑制或消耗含有组织囊肿的枯萎的肉类。原发性感染是免疫活性宿主的亚临床。侵袭性毒素病症常被显现为免疫抑制患者的脑毒素病。与人类免疫缺陷病毒(HIV)的生活中,当CD4计数非常低时,会发生弓形虫,被认为是一种患病的获得性免疫缺陷综合征(艾滋病)。在高度活跃的抗逆转录病毒治疗时代很少看到肺弓形虫病。由于临床和放射线摄影结果的非特异性,诊断可能是挑战性的。在本报告中,我们在新的发病助剂患者中提出了一种肺弓形病的案例,其最初是临床误诊为肺肺炎肠道肺炎(PJP)。由于对PJP治疗的反应不佳,患者接受了跨血管肺活检,这导致了肺组织病的诊断。

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