Israelski D M, Remington J S
Department of Medicine, Stanford University School of Medicine, California.
Clin Infect Dis. 1993 Nov;17 Suppl 2:S423-35. doi: 10.1093/clinids/17.supplement_2.s423.
The unusual occurrence, protein manifestations, and often devastating consequences of toxoplasmosis in patients with cancer emphasize the need for clinical acumen in the diagnosis and management of this disorder. Toxoplasmosis in patients with cancer has most commonly been described in association with Hodgkin's disease. It has also been reported, usually in the setting of treatment with antineoplastic agents, in patients with other lymphoproliferative disorders, hematologic malignancies, and solid tumors. In this review, among patients for whom the diagnosis was made early enough to begin specific treatment, conditions of 68% improved; this finding was in marked contrast to the severe morbidity and mortality observed for untreated individuals. The high mortality in the untreated group reflects the general debilitation and severe immunocompromise of these patients. Therefore, although toxoplasmosis contributed to a poor prognosis, it was not necessarily always the proximate cause of death.
癌症患者中弓形虫病的异常发生、蛋白质表现以及常常具有的毁灭性后果,凸显了在诊断和管理这种疾病时临床敏锐度的必要性。癌症患者中的弓形虫病最常被描述为与霍奇金病相关。在其他淋巴增殖性疾病、血液系统恶性肿瘤和实体瘤患者中也有报道,通常是在接受抗肿瘤药物治疗的情况下。在本综述中,对于诊断足够早从而能够开始特异性治疗的患者,68%的病情得到改善;这一发现与未治疗个体所观察到的严重发病率和死亡率形成鲜明对比。未治疗组的高死亡率反映了这些患者普遍的身体虚弱和严重免疫功能低下。因此,虽然弓形虫病导致了预后不良,但它不一定总是直接死因。