TABLE 4.

Clinical features and treatment for the 16 patients with severe acquired toxoplasmosis

Symptom or treatmentResult for patient:
12345678910111213141516Total
General symptoms
    Temp of >39°CYesYesYesYesYesYesYesYesYesYesYesYesYesYesYesYes16
    Wt loss (kg)3?3108Yes (?)Yes (?)106631075?1014
Elevated liver enzymesYesYesYesYesNoYesYesYesYesYesYesYesYesYesYesYes15
Pulmonary involvementYesYesYesYesYesYesYesYesYesNoNoYesYesYesYesYes14
    Cough without pneumoniaYesNoYesYesNoNoNoNoYesNoNoYesNoNoNoNo5
    PneumoniaNoYesNoNoYesYesYesYesNoNoNoNoYesYesYesYes9
    Chest X rayBilateral interstitial infiltratesBilateral interstitial infiltratesBilateral interstitial infiltratesBilateral interstitial infiltratesBilateral interstitial infiltratesBilateral alveolar- interstitial infiltratesBilateral alveolar infiltratesBilateral interstitial infiltratesBilateral interstitial infiltrates
    Respiratory distressNoNoYesYesNoNoNoYesYesYes4
Severe HeadacheNoYesYesYesYesNoNoYesYesNoYesNoYesYesNoNo9
SplenomegalyYesYesNoNoYesNoNoYesNoYesYesYesNoNoYesNo8
Peripheral adenopathyAxillary inguinalNoCervicalAxillaryNoNoNoNoCervicalAxillaryNoCervicalNoInguinalAxillary inguinalCervical, inguinal9
HepatomegalyYesYesNoNoNoYesYesNoNoNoNoNoYesNoNoNo5
DiarrheaNoYesYesNoNoNoNoNoNoYesYesYesNoYesNoNo6
ChorioretinitisNoYesNoYesNoNoYesNoNoNoNoNoNoNoNoNo4
    Decreased visual     acuityYes (unilateral)Yes (unilateral)Yes (unilateral)
    No. of lesions221
    Topography of     lesionsPeripheralJuxtamacularPeripheral
    HyalitisYesYesYes
Treatment
    Antitoxoplasmosis     drug(s)aPy + SulPy + SulPy + SulSpPy + SulPy + SulPy + SulPy + SulSpPy + SulPy + SulSpPy + SulPy + SulPy + SulPy + Sulb
    Delay for apyrexia     (days)75415710?6136310553012c
  • a Py, pyrimethamine; Sul, sulfadiazine; Sp, spiramycin.

  • b Total number of patients treated with spiramycin, 3; total number of patients treated with pyramethamine plus sulfadiazine, 13.

  • c For treatment with spiramycin, the median delay was 13 days (mean, 12.7 days), and for treatment with pyramethamine plus sulfadiazine, the median delay was 6 days (mean, 6.4 days). The delay for patient 15 was not taken into account when calculating the mean and median, because this patient, who had sickle cell anemia, had persistent fever due to nosocomial complications.