title: Toxoplasmic myocarditis and polymyositis in patients with acute acquired toxoplasmosis diagnosed during life.
abstract: The presence of both toxoplasmic myocarditis and myositis in the same individual has been reported only at autopsy. We report the first case of biopsy-proven toxoplasmic myocarditis and polymyositis simultaneously occurring in the same individual that was diagnosed during life. Results of her toxoplasmic serology were consistent with acute toxoplasmosis. She subsequently developed visual symptoms consistent with toxoplasmic chorioretinitis. She had a positive clinical response to therapeutic agents specific against Toxoplasma gondii. Her toxoplasmic serological profile established the diagnosis of acute toxoplasmosis. A toxoplasmic serological profile should be obtained for patients with myocarditis and/or polymyositis of unclear etiology. Endomyocardial or skeletal muscle tissue biopsies may establish the definitive diagnosis of toxoplasmic myocarditis or polymyositis, respectively. Examination of blood by polymerase chain reaction analysis before antitoxoplasmic treatment and early in the course of primary infection with T. gondii may prove useful.
authors.affiliation: Department of Immunology and Infectious Diseases, Palo Alto Medical Foundation, Research Institute, Veterans Affairs Palo Alto Health Care System, California 94301, USA.
authors.forename: J G
authors.initials: JG
authors.lastname: Montoya
authors.forename: R
authors.initials: R
authors.lastname: Jordan
authors.forename: S
authors.initials: S
authors.lastname: Lingamneni
authors.forename: G J
authors.initials: GJ
authors.lastname: Berry
authors.forename: J S
authors.initials: JS
authors.lastname: Remington
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000150:complications* / Q000469:parasitology / Q000473:pathology / Q000628:therapy; D017285:Polymyositis / Q000150:complications* / Q000469:parasitology / Q000473:pathology / Q000628:therapy; D014123:Toxoplasmosis / Q000150:complications* / Q000469:parasitology