Abstract
1 Department of Infectious Diseases, Hopital Bichat, Paris Diderot University, Paris, France, 2 Department of Parasitology and Mycology, Hopital Bichat, Paris Diderot University, Paris, France, 3 National Reference Centre on Toxoplasmosis and Biological Resource Centre Toxoplasma, EA3800, Department of Parasitology and Mycology, CHU Maison Blanche, University of Reims Champagne-Ardenne, Reims, France, 4 INSERM UMR 1094, Tropical Neuroepidemiology, Department of Parasitology and Mycology, University of Limoges, Limoges, France, 5 EA 3593, Department of Parasitology and Mycology, Cayenne Hospital, University of the Antilles and Guyana, Cayenne, French Guiana
Highlights
Haematological blood tests revealed a haemoglobin level of 137 g/l with signs of haemolysis, a total white blood cell count of 11.16109/L (69% granulocytes, 21% lymphocytes), and thrombocytosis (3926109/L platelets)
There are many diagnoses that can lead to subacute fever, hepatitis, pancreatitis, and pneumonia in a patient coming from the Amazonian region
Toxoplasma gondii, Herpes simplex viruses, Epstein-Barr virus (EBV), and Varicella-zoster virus DNA were not detected by polymerase chain reaction (PCR) in the cerebrospinal fluid
Summary
A 33-year-old man living in Cayenne, French Guiana, was admitted in the Bichat hospital in Paris with a 3-week history of fever associated with dyspnea and confusion. A chest X-ray previously made in French Guiana showed an alveolar infiltrate of the middle lobe. Physical examination revealed a loss of 4 kilograms in the last month, confusion, hypotension (98/63 mmHg), tachycardia (126 beats per minute), a red but painless left eye, congestive heart failure, fine crackles in the right lung field, and a onecentimetre-wide left axillary node. Haematological blood tests revealed a haemoglobin level of 137 g/l with signs of haemolysis (elevated lactic dehydrogenase, low haptoglobin), a total white blood cell count of 11.16109/L (69% granulocytes, 21% lymphocytes), and thrombocytosis (3926109/L platelets). The blood film showed stigmata of mononucleosis syndrome. Mild hepatitis, pancreatitis, and elevated cardiac markers.
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