PULMONARY TOXOPLASMOSIS IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS - A FRENCH NATIONAL SURVEY

We reviewed all cases of pulmonary toxoplasmosis (PT) that were docume nted by detection of Toxoplasma gondii in bronchoalveolar lavage fluid specimens during a French nationwide review of extracerebral toxoplas mosis in patients infected with human immunodeficiency virus (HIV). On ly 64 cases of proven PT were recorded during the 33-month survey. The patients were similar to other patients with AIDS in terms of age, se x, and risk factors for HIV infection. PT occurred mainly in patients with advanced immunodeficiency (mean [+/-SD] CD4(+) lymphocyte count, 40 +/- 75/mm(3)). Clinical features of PT usually included fever, coug h, and dyspnea; the associated radiological findings were mainly diffu se interstitial infiltrates. Serological data were uninformative. The treatment for PT was the same as that for cerebral toxoplasmosis. A cl inical response was observed for 47% of patients, 23% of whom relapsed . Twenty-four patients (37%) died of toxoplasmosis, and 17 (27%) died of other causes. The median survival time was 150 days. We conclude th at PT is an infrequent but severe infection in HIV-infected patients i n France.