title: Severe acquired toxoplasmosis in immunocompetent adult patients in French Guiana.
abstract: The most common presentation of symptomatic postnatally acquired toxoplasmosis in immunocompetent patients is painless cervical adenopathy. Acute visceral manifestations are associated in rare cases. We report 16 cases of severe primary toxoplasmosis diagnosed in French Guiana during a 6.5-year period. All of the subjects were immunocompetent adults hospitalized with clinical presentations consisting of a marked, nonspecific infectious syndrome accompanied by an altered general status with at least one visceral localization, mainly pulmonary involvement (14 cases). Acute toxoplasmosis was diagnosed according to the results of serological tests suggestive of recent primary infection and the absence of an alternative etiology. Recovery was rapid following specific antitoxoplasmosis treatment. Thirteen of the 16 patients had consumed game in the 2 weeks before the onset of the symptoms, and in eight cases the game was considered to have been undercooked. Toxoplasma strains, which were virulent in mice, were isolated from three patients. Microsatellite analysis showed that all of these isolates exhibited an atypical multilocus genotype, with one allele found only for isolates of this region.
authors.affiliation: Parasitologie-Mycologie, EA 3593 UFR de Médecine (Université Antilles Guyane) et Centre Hospitalier de Cayenne. Service de Médecine B, Centre Hospitalier de Cayenne, F 97306 Cayenne, France. b.carme@nplus.gf
authors.forename: B
authors.initials: B
authors.lastname: Carme
authors.forename: F
authors.initials: F
authors.lastname: Bissuel
authors.forename: D
authors.initials: D
authors.lastname: Ajzenberg
authors.forename: R
authors.initials: R
authors.lastname: Bouyne
authors.forename: C
authors.initials: C
authors.lastname: Aznar
authors.forename: M
authors.initials: M
authors.lastname: Demar
authors.forename: S
authors.initials: S
authors.lastname: Bichat
authors.forename: D
authors.initials: D
authors.lastname: Louvel
authors.forename: A M
authors.initials: AM
authors.lastname: Bourbigot
authors.forename: C
authors.initials: C
authors.lastname: Peneau
authors.forename: P
authors.initials: P
authors.lastname: Neron
authors.forename: M L
authors.initials: ML
authors.lastname: Dardé
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D016054:DNA, Protozoan / Q000032:analysis; D005616:French Guiana / Q000453:epidemiology; D005838:Genotype; D006801:Humans; D007121:Immunocompetence; D015994:Incidence; D008297:Male; D051379:Mice; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012720:Severity of Illness Index; D014122:Toxoplasma / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000469:parasitology / Q000503:physiopathology*
chemical_list: D000913:Antibodies, Protozoan; D016054:DNA, Protozoan