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Acute acquired toxoplasmosis: clinical-laboratorial aspects and ophthalmologic evaluation in a cohort of immunocompetent Patients
Neves, E.S.; Bicudo, L.N.; Curi, A.L.; Carregal, E.; Bueno, W.F.; Ferreira, R.G.; Amendoeira, M.R.; Benchimol, E. & Fernandes, O.
Abstract
Most cases of acute acquired toxoplasmosis (AAT) are oligosymptomatic and self-limited. Therefore, these infections
rarely indicate treatment. Prospective studies of AAT patients are rare in the medical literature. The frequency
of systemic manifestations has not been sufficiently studied. In order to search for risks factors for systemic and
ocular involvement, 37 patients were submitted to a diagnostic investigative protocol. The most frequent findings
were lymph node enlargement (94.6%), asthenia (86.5%), headache (70.3%), fever (67.6%) and weight loss (62.2%).
Hepatomegaly and/or splenomegaly were present in 21.6% of cases (8/37). Liver transaminases were elevated in 11
patients (29.7%) and lactic dehydrogenase in 17 patients (45.9%). Anaemia was found in four patients (10.8%), leucopoenia
in six patients (16.2%), lymphocytosis in 14 patients (37.8%) and thrombocytopenia in one patient (2.7%).
Fundoscopic examination revealed retinochoroiditis in four patients (10.8%). No statistical association was found
between any one morbidity and retinochoroiditis. Nevertheless, a significant association was found between the
presence of more than eight morbidity features at evaluation and long-lasting disease. An ideal diagnostic protocol
for AAT would include evidence of systemic involvement. Such a protocol could be used when planning treatment.
Keywords
toxoplasmosis - retinochoroiditis - hepatomegaly - morbidity - Toxoplasma gondii
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