Toxoplasma pneumonia and other parasitic pulmonary infections in HIV-infected patients
- Rajesh T Gandhi, MD
Rajesh T Gandhi, MD
- Associate Professor of Medicine
- Harvard Medical School
- Section Editors
- Paul E Sax, MD
Paul E Sax, MD
- Section Editor — HIV
- Clinical Director, Division of Infectious Diseases
- Brigham and Women's Hospital
- Professor of Medicine
- Harvard Medical School
- John G Bartlett, MD
John G Bartlett, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — HIV; Pulmonary Infections
- Professor Emeritus
- Johns Hopkins University School of Medicine
Prior to the era of potent antiretroviral therapy, parasitic pulmonary infections were more commonly seen than they are today. However, the clinician still needs to be aware of presenting symptoms and signs of these uncommon infections, which may occur in the immunosuppressed patient with untreated or drug-resistant HIV infection.
This topic will address pulmonary infections related to Toxoplasma gondii, Strongyloides stercoralis, Cryptosporidium, and Microsporidium . A more general overview of pulmonary disease in the HIV-infected patient is found elsewhere. (See "Approach to the HIV-infected patient with pulmonary symptoms".)
T. gondii is a ubiquitous intracellular protozoan. Although T. gondii can infect a wide range of vertebrates, feral and domestic cats are the definitive hosts. The organism undergoes its complete life cycle in the cat, resulting in the production of oocytes, which are passed with the feces into soil. Oocytes may remain infective for over one year. If ingested, Toxoplasma can invade tissue and reproduce.
The two routes of transmission to humans are:
●Ingestion of food or beverages contaminated with sporulated oocytesTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- Clinical presentation
- Differential diagnosis
- OTHER PARASITIC PULMONARY INFECTIONS
- Cryptosporidium and microsporidium
- WHEN TO INITIATE ANTIRETROVIRAL THERAPY
- SOCIETY GUIDELINE LINKS
- SUMMARY AND RECOMMENDATIONS