原发性弓形体病感染合并噬血细胞综合征一例报告：附文献复习。
Primary Toxoplasma gondii infection-associated with hemophagocytic syndrome in a man with HIV infection: a case report.
机构信息
Department of Infectious Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China.
BGI Pathogenesis Pharmaceutical TechnologyBGI-Shenzhen, Shenzhen, Guangdong Province, China.
出版信息
BMC Infect Dis. 2022 Jan 6;22(1):35. doi: 10.1186/s12879-021-07022-6.
BACKGROUND
Reactivation of latent Toxoplasma gondii (T. gondii) infection is more common than primary infection in patients with human immunodeficiency virus (HIV). We report a rare case of primary T. gondii infection-associated hemophagocytic syndrome (HPS).
CASE PRESENTATION
A man with HIV infection presented with fever, dyspnea and pancytopenia. He was diagnosed with primary T. gondii infection by the seroconversion from single-positive IgM antibody to double-positive IgM and IgG antibody. Metagenomic next-generation sequencing (mNGS) of a plasma sample yielded high reads of T. gondii DNA. He responded well to combined anti-Toxoplasma medicines and glucocorticoid treatment.
CONCLUSIONS
In patients with HPS and positive T. gondii IgM antibody, mNGS analysis of a peripheral blood sample is helpful in diagnosing disseminated T. gondii infection. The dynamic changes by serological detection for IgM and IgG of T. gondii further supported the inference that the patient has experienced a primary T. gondii infection.
背景
潜伏的刚地弓形虫（Toxoplasma gondii）感染在人类免疫缺陷病毒（HIV）患者中比原发性感染更为常见。我们报告了一例罕见的原发性刚地弓形虫感染相关噬血细胞综合征（HPS）病例。
病例介绍
一名 HIV 感染男性出现发热、呼吸困难和全血细胞减少。他的血清学检测从单一阳性 IgM 抗体转变为双阳性 IgM 和 IgG 抗体，被诊断为原发性刚地弓形虫感染。血浆样本的宏基因组下一代测序（mNGS）显示刚地弓形虫 DNA 的高读长。他对联合抗弓形虫药物和糖皮质激素治疗反应良好。
结论
在 HPS 患者和阳性刚地弓形虫 IgM 抗体患者中，外周血样本的 mNGS 分析有助于诊断播散性刚地弓形虫感染。刚地弓形虫 IgM 和 IgG 的血清学检测的动态变化进一步支持了患者经历原发性刚地弓形虫感染的推断。
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