       Document 0627
 DOCN  M9550627
 TI    Value of PCR for evaluating occurrence of parasitemia in
       immunocompromised patients with cerebral and extracerebral
       toxoplasmosis.
 DT    9505
 AU    Khalifa K el-S; Roth A; Roth B; Arasteh KN; Janitschke K; Fachgebiet fur
       Klinische Parasitologie, Robert Koch-Institute,; Berlin, Germany.
 SO    J Clin Microbiol. 1994 Nov;32(11):2813-9. Unique Identifier : AIDSLINE
       MED/95155603
 AB    PCR was used to evaluate the occurrence of Toxoplasma gondii parasitemia
       by detection of the B1 gene in blood samples in two groups of
       immunosuppressed patients (148 subjects) suspected of having cerebral or
       extracerebral infection, respectively. Group I consisted of 52 patients
       with AIDS with suspected cerebral toxoplasmosis. The diagnosis was
       clinically proven in 15 cases. Parasitemia was detected by PCR in only
       two of these patients (13.3%), both showing evidence of disseminated
       infection. Group II consisted of 96 immunocompromised patients, either
       with AIDS or receiving iatrogenic immunosuppressive therapy. Of these
       patients, 65 (34 with AIDS and 31 others) showed abnormalities only in
       chest radiography and were first screened for the presence of Toxoplasma
       DNA in bronchoalveolar lavage fluid. Blood was then analyzed when the
       parasite was detected in the bronchoalveolar lavage fluid. The remaining
       31 subjects (22 with AIDS and 9 others) were suspected of having
       extracerebral, pulmonary, or disseminated toxoplasmosis, and blood was
       studied directly in these cases. Among the nine patients with clinically
       diagnosed extracerebral infection in group II, the parasite was detected
       by PCR in the blood of five patients (55.5%), all having pulmonary
       toxoplasmosis. If all patients with clinical manifestations of
       extracerebral toxoplasmosis (from both groups) who had not received
       antitoxoplasma therapy when the samples were collected are considered,
       PCR detected parasitemia in seven of the nine cases (77.8%). The present
       study indicates that examination of blood by PCR may be valuable in
       cases of extracerebral toxoplasmosis because of the disseminated nature
       of the disease. Since most cases of cerebral toxoplasmosis result from
       the local reactivation of latent brain cysts, detection of parasitemia
       by PCR is useful only in cases associated with severe cerebral infection
       or dissemination of this disease.
 DE    Acquired Immunodeficiency Syndrome/PARASITOLOGY  Animal  Base Sequence
       DNA, Protozoan/*ANALYSIS  Human  Immunocompromised Host  Mice  Molecular
       Sequence Data  Parasitemia/*DIAGNOSIS  *Polymerase Chain Reaction
       Sensitivity and Specificity  Toxoplasma/*GENETICS
       Toxoplasmosis/*DIAGNOSIS  Toxoplasmosis, Cerebral/*DIAGNOSIS  JOURNAL
       ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

