Stagno S, Dykes A C, Amos C S, Head R A, Juranek D D, Walls K
Pediatrics. 1980 Apr;65(4):706-12.
Clinical, serologic, and epidermiologic evidence documents an outbreak of toxoplasmosis involving ten of 30 members of an extended family. The index patient had unusual clinical manifestations including brain abscesses, progressive chorioretinitis, seizures, neurologic deficits, hepatosplenomegaly, pneumonitis, and eosinophilia. Toxoplasmosis was confirmed by demonstrating the organism in brain tissue and cerebrospinal fluids; clinical and serologic evidence also indicated infection with Toxocara (viscd children. Of the 11 such children, seven (68%) were seropositive, six of whom had high acute-phase titers (greater than or equal to 1024) to Toxoplasma and a disease consistent with acute toxoplasmosis. All six of the latter group required specific chemotherapy. Geophagia was associated statistically with acute toxoplasmosis among the children; it also increased the risk of infection with Toxocara and enteroparasites. Two school-aged children and two adults had serologic evidence of acute toxoplasmosis, but only one of the group was symptomatic. Epidemiologic evidence indicates that this outbreak was probably caused by ingesting oocysts from cat feces. We suggest that the severe and unusual clinical manifestations of the index patient resulted from simultaneous infection with Toxoplasma and Toxocara.
临床、血清学和流行病学证据证明，一个大家庭的30名成员中有10人爆发了弓形虫病。首例患者有不同寻常的临床表现，包括脑脓肿、进行性脉络膜视网膜炎、癫痫发作、神经功能缺损、肝脾肿大、肺炎和嗜酸性粒细胞增多。通过在脑组织和脑脊液中发现病原体确诊为弓形虫病；临床和血清学证据还表明感染了犬弓蛔虫（感染了儿童。在11名此类儿童中，7名（68%）血清呈阳性，其中6名对弓形虫急性期滴度高（大于或等于1024）且患有与急性弓形虫病相符的疾病。后一组中的所有6名儿童均需要进行特异性化疗。在儿童中，食土癖与急性弓形虫病在统计学上相关；它还增加了感染犬弓蛔虫和肠道寄生虫的风险。两名学龄儿童和两名成年人有急性弓形虫病的血清学证据，但该组中只有一人有症状。流行病学证据表明，此次疫情可能是由于摄入猫粪中的卵囊所致。我们认为首例患者严重且不同寻常的临床表现是由同时感染弓形虫和犬弓蛔虫引起的。
