Skip to main content

Advertisement

SpringerLink
Log in

Severe polymyositis due to Toxoplasma gondii in an adult immunocompetent patient: a case report and review of the literature

  • Case Report
  • Published:
Infection Aims and scope Submit manuscript

Abstract

Toxoplasmosis, a worldwide zoonosis caused by a coccidian parasite Toxoplasma gondii, is more often asymptomatic in immunocompetent patients. We report the case of a 38-year-old immunocompetent male with a polymyositis as the presenting manifestation of T. gondii infection. The patient was hospitalized for a 30-day history of fever (T max 39.5°C), muscle pain, and progressive weakness of the muscles. A diagnosis of polymyositis was made, and he was started on corticosteroid treatment, which caused no reduction of symptoms. After finding a positive polymerase chain reaction (PCR) assay for T. gondii, together with additional clinical findings, a diagnosis of acute toxoplasmosis was made. Specific treatment with pyrimethamine and sulfadiazine was started, with a progressive reduction of symptoms and normalization of laboratory tests.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Tenter AM, Heckeroth AR, Weiss LM. Toxoplasma gondii: from animals to humans. Int J Parasitol. 2000;30:1217–58.

    Article  PubMed  CAS  Google Scholar 

  2. Montoya JG, Liesenfeld O. Toxoplasmosis. Lancet. 2004;363:1965–76.

    Article  PubMed  CAS  Google Scholar 

  3. Lefevre-Pettazzoni M, Le Cam S, Wallon M, et al. Delayed maturation of immunoglobulin G avidity: implication for the diagnosis of toxoplasmosis in pregnant women. Eur J Clin Microbiol Infect Dis. 2006;25:687–93.

    Article  PubMed  CAS  Google Scholar 

  4. Gherardi R, Baudrimont M, Lionnet F, et al. Skeletal muscle toxoplasmosis in patients with acquired immunodeficiency syndrome: a clinical and pathological study. Ann Neurol. 1992;32:535–42.

    Article  PubMed  CAS  Google Scholar 

  5. Plonquet A, Bassez G, Authier FJ, et al. Toxoplasmic myositis as a presenting manifestation of idiopathic CD4 lymphocytopenia. Muscle Nerve. 2003;27:761–5.

    Article  PubMed  Google Scholar 

  6. Montoya JG, Jordan R, Lingamneni S, et al. Toxoplasmic myocarditis and polymyositis in patients with acute acquired toxoplasmosis diagnosed during life. Clin Infect Dis. 1997;24:676–83.

    Article  PubMed  CAS  Google Scholar 

  7. Calore EE, Minkovski R, Khoury Z, et al. Skeletal muscle pathology in 2 siblings infected with Toxoplasma gondii. J Rheumatol. 2000;27:1556–9.

    PubMed  CAS  Google Scholar 

  8. Hassene A, Vital A, Anghel A, et al. Acute acquired toxoplasmosis presenting as polymyositis and chorioretinitis in immunocompetent patient. Joint Bone Spine. 2008;75:603–5.

    Article  PubMed  Google Scholar 

  9. Nunura J, Vásquez T, Endo S, et al. Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon. Rev Inst Med Trop Sao Paulo. 2010;52:107–10.

    PubMed  Google Scholar 

  10. Cuturic M, Hayat GR, Vogler CA, et al. Toxoplasmic polymyositis revisited: case report and review of literature. Neuromuscul Disord. 1997;7:390–6.

    Article  PubMed  CAS  Google Scholar 

  11. Roig Quilis M, Damjanov I. Dermatomyositis as an immunologic complication of toxoplasmosis. Acta Neuropathol. 1982;58:183–6.

    Article  PubMed  CAS  Google Scholar 

  12. Matsubara S, Takamori M, Adachi H, et al. Acute Toxoplasma myositis: an immunohistochemical and ultrastructural study. Acta Neuropathol. 1990;81:223–7.

    Article  PubMed  CAS  Google Scholar 

  13. Shapira Y, Agmon-Levin N, Selmi C, et al. Prevalence of anti-Toxoplasma antibodies in patients with autoimmune diseases. J Autoimmun. 2012;39:112–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Infectious Disease Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy

    G. Cuomo, V. Rizzo, S. Nardiello & G. B. Gaeta

  2. Rheumatology Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy

    V. D’Abrosca, G. La Montagna & G. Valentini

Authors
  1. G. Cuomo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. D’Abrosca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Rizzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Nardiello
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. La Montagna
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. B. Gaeta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G. Valentini
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Valentini.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cuomo, G., D’Abrosca, V., Rizzo, V. et al. Severe polymyositis due to Toxoplasma gondii in an adult immunocompetent patient: a case report and review of the literature. Infection 41, 859–862 (2013). https://doi.org/10.1007/s15010-013-0427-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s15010-013-0427-x

Keywords

Search

Navigation