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CASE REPORT
A rare case of pulmonary toxoplasmosis in a patient with undifferentiated inflammatory arthritis on chronic methotrexate and corticosteroid therapy
  1. Abdullateef Abdulkareem1,
  2. Ryan Steven D'Souza2,
  3. Nitin Patel3,
  4. Anthony A Donato4
  1. 1Department of Internal Medicine, Reading Hospital and Medical Center, West Reading, Pennsylvania, USA
  2. 2Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota, USA
  3. 3Reading Health Physician Network Infectious Disease, Reading Hospital and Medicine Center, West Reading, Pennsylvania, USA
  4. 4Department of Internal Medicine, Reading Hospital and Medical Center, West Reading, Pennsylvania, USA
  1. Correspondence to Dr Abdullateef Abdulkareem, dayo.abdulkareem{at}readinghealth.org

Summary

Pulmonary toxoplasmosis is a serious pulmonary condition caused by the protozoan Toxoplasma gondii. It typically affects immunocompromised patients presenting acutely with cough, fever, myalgias, arthralgias and lymphadenopathy, and chronically with persistent cough and dyspnoea. Because of its protean features, it can mimic many more common lung conditions in the immunocompromised patient, including atypical pneumonia, Pneumocystis pneumonia and interstitial lung disease. In this article, we present the case of a 55-year-old woman who presented to our hospital with persistent dyspnoea and cough, initially suspected to have an arthritis-related interstitial lung disease. She received a final diagnosis of pulmonary toxoplasmosis after lung biopsy demonstrated Toxoplasma cysts, later confirmed by serology. Treatment with trimethoprim–sulfamethoxazole resulted in significant improvement of her respiratory symptoms after 3 months.

  • infections
  • respiratory system
  • drugs: infectious diseases
  • drugs:musculoskeletal and joint diseases
  • rheumatoid arthritis

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Footnotes

  • Contributors AA and RSD collected data, performed conception/background research/design/analysis/interpretation of data, and composed the manuscript. NP served as a scientific advisor, participated in the conception of case report, provided and cared for the study patient, and critically reviewed the study proposal. AAD served as a scientific advisor, participated in the conception of case report and critically reviewed the study proposal.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.