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Acute fulminant toxoplasma meningoencephalitis in a homosexual man

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Summary

A homosexual man with a history of sexually transmitted infections including recent giardiasis and high cytomegalovirus (CMV) titer was admitted with generalized weakness, headache, and depression. He rapidly became comatose and developed signs of increased intracranial pressure. CT scan revealed a right cerebral lesion. Pathologic examination disclosed an acute necrotizing granulomatous toxoplasmosis involving the cerebrum. This case represents an example of an opportunistic infection in a male homosexual associated with fulminant clinical course, probably on the basis of immune deficiency.

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References

  1. Best T, Finlayson M (1979) Two forms of encephalitis in opportunistic toxoplasmosis. Arch Pathol Lab Med 103:693–696

    Google Scholar 

  2. Cooper HS, Patchefsky AS, Marko G (1979) Cloacogenic carcinoma of the anorectum in homosexual men: an observation of four cases. Dis Colon Rectum 22:557–558

    Google Scholar 

  3. Curran JW and the members of the Task Force (1982) Report of the Centers for Disease Control and Task Force on Kaposi's sarcoma and opportunistic infections. Epidermiologic aspects of the current outbreak of Kaposi's sarcoma and opportunistic infections. New Engl J Med 306:248–252

    Google Scholar 

  4. Daling JR, Weiss NS, Klopfenstein LL, Cochran LE, Chow WH, Daifuku R (1982) Correlates of homosexual behavior and the incidence of anal cancer. JAMA 247:1988–1990

    Google Scholar 

  5. Drew WL, Mintz L, Miner RC, Sands M, Ketterer B (1981) Prevalence of cytomegalovirus infection in homosexual men. J Infect Dis 143:188–192

    Google Scholar 

  6. Fauci AS (1982) The syndrome of Kaposi's sarcoma and opportunistic infections: an epidemiologically restricted disorder of immunoregulation. Ann Int Med 96:777–779

    Google Scholar 

  7. Follansbee SE, Busch DF, Wofsy CB, Coleman DL, Gullet J, Aurigemma GP, Ross T, Hadley WK, Drew WL (1982) An outbreak of pneumocystic carinii pneumonia in homosexual men. Ann Int Med 96:705–713

    Google Scholar 

  8. Frenkel JK (1949) Pathogenesis, diagnosis and treatment of human toxoplasmosis. JAMA 140:369–378

    Google Scholar 

  9. Friedman-Kien A, Laubenstein LJ, Rubinstein P, Buimovici-Klein E, Marmor M, Stahl R, Spigland I, Kim KS, Zolla-Pazner S (1982) Disseminated Kaposi's sarcoma in homosexual men. Ann Int Med 96:693–700

    Google Scholar 

  10. Friedman-Kien A (1981) Centers for Disease Control, report of the US Department of Health and Human Services on Kaposi's sarcoma and pneumocystis pneumonia among homosexual men — New York City and California. Morbid Mortal Weekly Rep 30:305–308

    Google Scholar 

  11. Gold KD, Thomas L, Garrett TJ (1982) Aggressive Kaposi's sarcoma in a heterosexual drug addict. New Engl J Med 307:498

    Google Scholar 

  12. Gottlieb MS, Schroff R, Schanker HM, Weisman JD, Fan PT, Wolf RA, Saxon A (1981) Pneumocystis carinii pneumonia and mucosal candidiasis in previously healthy homosexual men: evidence of a new acquired cellular immunodeficiency. New Engl J Med 305:1425–1431

    Google Scholar 

  13. Hanrahan JP, Wormser GP, Maguire GP, DeLorenzo LJ, Gavis G (1982) Opportunistic infections in prisoners. New Engl J Med 307:498

    Google Scholar 

  14. Hauser WE, Luft BJ, Conley FK, Remington JS (1982) Central nervous system toxoplasmosis in homosexual and heterosexual adults. New Engl J Med 307:498–499

    Google Scholar 

  15. Judson FN, Penley KA, Robinson ME, Smith JK (1980) Comparative prevalence rates of sexually transmitted diseases in heterosexual and homosexual men. Am J Epidemiol 112:836–843

    Google Scholar 

  16. Kass EH, Andrus SB, Adams RD, Turner FC, Feldman HA (1952) Toxoplasmosis in the human adult. Arch Int Med 89:759–782

    Google Scholar 

  17. Lang DJ, Kummer JF (1972) Demonstration of cytomegalovirus in semen. New Engl J Med 287:756–758

    Google Scholar 

  18. Lang, DJ, Kummer JF (1975) Cytomegalovirus in semen: observations in selected populations. J Infect Dis 132:472–473

    Google Scholar 

  19. Lozada F, Silverman S, Conant M (1982) New outbreak of oral tumors, malignancies and infectious disease strikes young male homosexuals. Calif Dent J 10:39–42

    Google Scholar 

  20. McLeod R, Berry PF, Marshall WH, Jr, Hunt SA, Ryning FW, Remington JS (1979) Toxoplasmosis presenting as brain abscesses. Diagnosis by computerized tomography and cytology of aspirated purulent material. Am J Med 67:711–714

    Google Scholar 

  21. Mildvan D, Mathur U, Enlow RW, Romain PL, Winchester RJ, Colp C, Singman H, Adelsberg BR, Spigland I (1982) Opportunistic infections and immune deficiency in homosexual men. Ann Int Med 96:700–704

    Google Scholar 

  22. Morris L, Distenfeld A, Amorosi E, Karpatkin S (1982) Autoimmune thrombocytopenic purpura in homosexual men. Ann Int Med 96:714–717

    Google Scholar 

  23. Powell HC, Gibbs CJ, Jr, Lorenzo AM, Lampert PW, Gajdüsek DC (1978) Toxoplasmosis of the central nervous system in the adult. Electron microscopic observations. Acta Neuropathol (Berl) 41:211–216

    Google Scholar 

  24. Reynolds ES, Walls KW, Pfeiffer RI (1966) Generalized toxoplasmosis following renal transplantation. Arch Int Med 118:401–405

    Google Scholar 

  25. Rinaldo CR, Carney WP, Richter BS, Black PH, Hirsch MS (1980) Mechanisms of immunosuppression in cytomegaloviral mononucleosis. J Infect Dis 141:488–495

    Google Scholar 

  26. Rozenbaum W, Coulaud JP, Saimot AG, Klatzmann D, Mayaud C, Carette MF (1982) Multiple opportunistic infection in a male homosexual in France. Lancet 1:572–573

    Google Scholar 

  27. Ruskin J, Remington JS (1976) Toxoplasmosis in the compromised host. Ann Int Med 84:193–199

    Google Scholar 

  28. Sharp GC, Irvin WS, Tan EM, Gould RG, Holman HR (1972) Mixed connective tissue disease. An apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA). Am J Med 52:148–159

    Google Scholar 

  29. Stahl RE, Friedman-Kien A, Dubin R, Marmor M, Zolla-Pazner S (1982) Immunologic abnormalities in homosexual men. Relationship to Kaposi's sarcoma. Am J Med 73:171–178

    Google Scholar 

  30. Vietzke WM, Gelderman AH, Grimley PM, Valsamis MP (1968) Toxoplasmosis complicating malignancy. Cancer 21:816–827

    Google Scholar 

  31. Vilaseca J, Arnau JM, Bacardi R, Mieras C, Serrano A, Navarro C (1982) Kaposi's sarcoma andToxoplasma gondii brain abscess in a Spanish homosexual. Lancet 1:572

    Google Scholar 

  32. William DC, Shoockhoff HB, Felman YM, DeRamos SW (1978) High rates of enteric protozoal infections in selected homosexual men attending a venereal disease clinic. Sex Transm Dis 5:155–157

    Google Scholar 

  33. Ziegler JL, Drew WL, Miner RC, Mintz L, Rosenbaum E, Gershow J, Lennette ET, Greenspan J, Shillitoe E, Beckstead J, Casavant C, Yamamoto K (1982) Outbreak of Burkitt's-like lymphoma in homosexual men. Lancet 2:631–633

    Google Scholar 

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Authors and Affiliations

  1. Division of Neuropathology, Institute of Pathology, Case Western Reserve, University and University Hospitals of Cleveland, 2085 Adelbert Rd., 44106, Cleveland, OH, USA

    T. Wongmongkolrit & A. El-Naggar

  2. Dept. of Neurology, Case Western Reserve, University and University Hospitals of Cleveland, 44106, Cleveland, OH, USA

    S. -L. McPherson

  3. Division of Critical Care Medicine, Dept. of Medicine, Case Western Reserve, University and University Hospitals of Cleveland, 44106, Cleveland, OH, USA

    R. Hafner, A. Schnall & D. L. Jackson

  4. Dept. of Psychiatry, Case Western Reserve, University and University Hospitals of Cleveland, 44106, Cleveland, OH, USA

    V. Codispoti

  5. Division of Neuroradiology, Dept. of Radiology, Case Western Reserve, University and University Hospitals of Cleveland, 44106, Cleveland, OH, USA

    C. Bonstelle

Authors
  1. T. Wongmongkolrit
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  2. S. -L. McPherson
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  3. A. El-Naggar
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  4. R. Hafner
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  5. V. Codispoti
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  6. A. Schnall
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  7. D. L. Jackson
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  8. C. Bonstelle
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Wongmongkolrit, T., McPherson, S.L., El-Naggar, A. et al. Acute fulminant toxoplasma meningoencephalitis in a homosexual man. Acta Neuropathol 60, 305–308 (1983). https://doi.org/10.1007/BF00691882

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  • DOI: https://doi.org/10.1007/BF00691882

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