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

Infection. 2013 Aug;41(4):859-62. doi: 10.1007/s15010-013-0427-x. Epub 2013 Apr 1.

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.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Antiprotozoal Agents / therapeutic use
  • Humans
  • Male
  • Polymyositis / drug therapy
  • Polymyositis / etiology*
  • Polymyositis / parasitology
  • Polymyositis / pathology*
  • Pyrimethamine / therapeutic use
  • Sulfadiazine / therapeutic use
  • Toxoplasma / isolation & purification*
  • Toxoplasmosis / complications*
  • Toxoplasmosis / diagnosis*
  • Toxoplasmosis / drug therapy
  • Toxoplasmosis / parasitology
  • Treatment Outcome

Substances

  • Antiprotozoal Agents
  • Sulfadiazine
  • Pyrimethamine