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M94A3220.TXT
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1994-10-25
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Document 3220
DOCN M94A3220
TI Evaluation of cell culture in the diagnosis of cerebral and pulmonary
toxoplasmosis.
DT 9412
AU Contini C; Magno S; Romani R; Zenobi P; Angelici E; Cultrera R; Delia S;
Inst Infect and Resp Dis. University of Ferrara, Italy.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):126 (abstract no. PA0125). Unique
Identifier : AIDSLINE ICA10/94369355
AB OBJECTIVE: To evaluate T. gondii in blood, lung secretions [BAL], and
cerebrospinal fluid specimens [CSF] obtained from AIDS patients with
proven or suspected toxoplasmosis. METHODS: Samples were obtained from
12 AIDS patients (8 men, 4 women, age range 26-34 years, CD4+ cell
counts < 50/10(6)/ml) hospitalized between December 1993 and February
1994. Separated blood mononuclear cells [PBMC], BAL cell pellets and
non-concentrated CSF fluids were inoculated in MRC5 tissue cultures and
T. gondii was investigated after 12 h of culture with indirect
immunofluorescence. RESULTS: Isolation of T. gondii was made in 10
(83.3%) patients. Of these, four were on prophylaxis against
toxoplasmosis because of a past cerebral toxoplasmosis documented by
clinical features, CT-scan abnormalities, significant serology for
toxoplasma and positive response to anti-toxoplasma treatment; three had
respiratory disorders indicative of interstitial pneumonia, CT-scan
lesions not suggestive of brain toxoplasmic involvement, positive
serology for T. gondii (2 cases), which successfully responded to
anti-toxoplasma therapy. In these 7 patients, T. gondii organisms were
demonstrated in blood (6 cases), BAL (2 cases) and CSF (6 cases). In all
treated patients, cultures became negative or parasites were
morphologically abnormal. All samples tested underwent routine
cytological examination for Pneumocystis, Mycobacteria and fungi which
scored negative. In two cases (33.3%), BAL samples also detected
Cytomegalovirus. The other 3 patients had mild neurologic disorders
associated to toxoplasmic parasitemia in more blood samples.
CONCLUSIONS: The results obtained seem to argue: i) diagnosis by tissue
culture substantiates previous observations which indicate this method
sensitive and specific to provide evidence of infection; ii) tissue
culture allows diagnosis in cases with only pulmonary symptoms thus
suggesting a primary lung localization or disseminated toxoplasmosis;
iii) the isolated parasitemia should be properly evaluated since its
presence may correlate with the occurrence of clinical disease.
DE Adult Animal AIDS-Related Opportunistic Infections/BLOOD/CEREBROSPINAL
FLUID/ *DIAGNOSIS Brain/RADIOGRAPHY Female Human Lung Diseases,
Parasitic/BLOOD/CEREBROSPINAL FLUID/*DIAGNOSIS Lymphocytes/PARASITOLOGY
Male Tissue Culture/*METHODS Tomography, X-Ray Computed
Toxoplasma/*ISOLATION & PURIF Toxoplasmosis/BLOOD/CEREBROSPINAL
FLUID/*DIAGNOSIS Toxoplasmosis, Cerebral/BLOOD/CEREBROSPINAL
FLUID/*DIAGNOSIS MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).