title: Multiple and atypical opportunistic infections in a HIV patient with Toxoplasma myocarditis.
abstract: Opportunistic infections cause significant morbidity and mortality in patients infected with the human immunodeficiency virus (HIV). Multiple opportunistic infections can occur in a patient in the setting of severe immunodeficiency and can have atypical clinicoradiological presentation. Cardiac involvement has also been observed on autopsy in HIV-infected patients in the form of myocarditis, dilated cardiomyopathy, endocarditis, neoplasms, and drug-related cardiotoxicity. Mostly, the cardiac opportunistic infections are clinically asymptomatic, and sudden death due to these is extremely rare. We report a case of 44-year-old gentleman who presented with cough, pleuritic chest pain, and breathlessness and died of refractory shock due to myocarditis. At autopsy, he was found to have Toxoplasma myocarditis, Pneumocystis jirovecii pneumonia, and cytomegalovirus adrenalitis.
authors: Department of Histopathology, Post Graduate Institute of Medical Education & Research, (PGIMER), Sector-12, Chandigarh 160012, India.
authors: Amanjit
authors: A
authors: Bal
authors: Department of Pulmonary Medicine, Post Graduate Institute of Medical Education & Research, (PGIMER), Sector-12, Chandigarh 160012, India.
authors: Sahajal
authors: S
authors: Dhooria
authors: Department of Pulmonary Medicine, Post Graduate Institute of Medical Education & Research, (PGIMER), Sector-12, Chandigarh 160012, India.
authors: Ritesh
authors: R
authors: Agarwal
authors: Department of Radiodiagnosis, Post Graduate Institute of Medical Education & Research, (PGIMER), Sector-12, Chandigarh 160012, India.
authors: Mandeep
authors: M
authors: Garg
authors: Department of Histopathology, Post Graduate Institute of Medical Education & Research, (PGIMER), Sector-12, Chandigarh 160012, India. Electronic address: ashim126@gmail.com.
authors: Ashim
authors: A
authors: Das
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000473:pathology*; D000307:Adrenal Gland Diseases / Q000150:complications / Q000473:pathology; D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications / Q000473:pathology; D017809:Fatal Outcome; D015497:HIV-1; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications* / Q000473:pathology*; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000473:pathology; D014123:Toxoplasmosis / Q000150:complications* / Q000473:pathology*
keywords: CMV; Myocarditis; Necrotizing Pneumocystis pneumonia; Toxoplasma