トキソプラズマ性頸部リンパ節炎例

Abstract

Toxoplasmic lymphadenopathy is the most common clinical manifestation of acute acquired toxoplasma infection in normal individuals. The diagnosis is established by serologic methods. Acute toxoplasmic lymphadenopathy manifests many symptoms. We report a case of toxoplasmic lymphadenopathy presenting with hepatic dysfunction. The patient was a 37-year-old woman. On February 2008, she consulted the previous hospital with a two-day history of swelling in the retroauricular region. Laboratory examination showed slight hepatic dysfunction but did not show elevation of either leukocytes count or serum C-reactive protein (CRP). Although cephem antibiotic was administered, the symptoms did not resolve and she further developed fever and general fatigue. Twenty-one days after, she was referred to our hospital for further evaluation and treatment. The patient had nine cats. Laboratory examination performed in our hospital did not detect elevation of either leukocytes count or serum CRP but elevated serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were noted. The specific IgM and IgG for toxoplasma gondii were positive, suggesting toxoplasma infection. Acetylspiramycin was administered 1,800 mg daily for fifty days. The symptoms resolved soon after the treatment. The serum AST and ALT levels also decreased with improving symptoms. We conclude that in case of toxoplasma infection presenting with hepatic dysfunction, the serum levels of ALT and AST suggest a marker of progression of this disease.