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Toxoplasma pneumonia and other parasitic pulmonary infections in HIV-infected patients

Rajesh T Gandhi, MD
Section Editors
Paul E Sax, MD
John G Bartlett, MD
Deputy Editor
Jennifer Mitty, MD, MPH


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 [1]. 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 oocytes

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Literature review current through: Nov 2017. | This topic last updated: Sep 28, 2017.
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