title: Severe polymyositis due to Toxoplasma gondii in an adult immunocompetent patient: a case report and review of the literature.
abstract: Toxoplasmosis, a worldwide zoonosis caused by a coccidian parasite Toxoplasma gondii, is more often asymptomatic in immunocompetent patients. We report the case of a 38-year-old immunocompetent male with a polymyositis as the presenting manifestation of T. gondii infection. The patient was hospitalized for a 30-day history of fever (T max 39.5°C), muscle pain, and progressive weakness of the muscles. A diagnosis of polymyositis was made, and he was started on corticosteroid treatment, which caused no reduction of symptoms. After finding a positive polymerase chain reaction (PCR) assay for T. gondii, together with additional clinical findings, a diagnosis of acute toxoplasmosis was made. Specific treatment with pyrimethamine and sulfadiazine was started, with a progressive reduction of symptoms and normalization of laboratory tests.
authors.affiliation: Infectious Disease Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Cuomo
authors.forename: V
authors.initials: V
authors.lastname: D'Abrosca
authors.forename: V
authors.initials: V
authors.lastname: Rizzo
authors.forename: S
authors.initials: S
authors.lastname: Nardiello
authors.forename: G
authors.initials: G
authors.lastname: La Montagna
authors.forename: G B
authors.initials: GB
authors.lastname: Gaeta
authors.forename: G
authors.initials: G
authors.lastname: Valentini
mesh_terms: D000328:Adult; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D017285:Polymyositis / Q000188:drug therapy / Q000209:etiology* / Q000469:parasitology / Q000473:pathology*; D011739:Pyrimethamine / Q000627:therapeutic use; D013411:Sulfadiazine / Q000627:therapeutic use; D014122:Toxoplasma / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D016896:Treatment Outcome
chemical_list: D000981:Antiprotozoal Agents; D013411:Sulfadiazine; D011739:Pyrimethamine
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