Abstract:
:There have been several case reports, a total of 22 up to the present, of toxoplasma pericarditis. Out of them, in only a few cases the diagnosis was properly made with a proof of the microscopic presence of Toxoplasma gondii. This is the first report of toxoplasma pericarditis in which the presence of Toxoplasma gondii was detected by polymerase chain reaction of pericardial effusion. In addition, the previous reports will be reviewed, and compared to this present case. A 29-year-old woman, without immunosuppressant disorder, suffering from fever and orthopnea was admitted to our hospital. Blood chemistry findings indicated mild liver dysfunction and inflammation. Chest radiography showed cardiac enlargement. Electrocardiography showed sinus tachycardia and ST elevation. Echocardiography revealed a massive pericardial effusion. Pericardiocentesis demonstrated 638 ml of bloody fluid. Cytologic study of the fluid was class II for malignancy, and polymerase chain reaction to tuberculosis was negative. However, a high titer of the anti-toxoplasma antibody of 1: 20,480 (passive hemagglutination) indicated pericarditis caused by Toxoplasma gondii. Subsequently, Toxoplasma gondii was identified in the pericardial effusion by polymerase chain reaction. Clinical symptoms improved after pericardiocentesis, but 2 months later pericarditis recurred. Treatment was started with 800 mg acetylspiramycin daily but failed to improve the symptoms. Because of the development of pleuritis, treatment was changed to sulfadoxine 1,000 mg/pyrimethamine 50 mg. After the treatment with them, her symptoms improved. Only 22 cases of toxoplasma pericarditis have been reported worldwide and 15 of those cases were without immunosuppressant disorder. The usual symptoms at the onset of pericarditis without immunosuppressant disorder are fever, dyspnea and chest pain. Seven patients developed cardiac tamponade. Pericardiocentesis was performed in 8 cases and the pericardial fluid was hemorrhagic in 6. Pericardial thickening was detected in 5 cases. The diagnosis of toxoplasma infection is very difficult, because asymptomatic infection of Toxoplasma gondii is very common. Pericarditis is a disease difficult to confirm the etiology. Detection of Toxoplasma gondii in pericardial effusion by the polymerase chain reaction is very useful for its diagnosis.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Sano J,Saitoh H,Kobayashi Y,Ikeda M,Kodani E,Takayama M,Kishida H,Takano T,Yano Asubject
Has Abstractpub_date
2000-01-01 00:00:00pages
47-54issue
1eissn
0914-5087issn
1876-4738journal_volume
35pub_type
杂志文章,评审abstract:BACKGROUND:Cardiac resynchronization therapy (CRT) is an established treatment modality for advanced heart failure (HF) but 20-30% of patients treated with CRT do not experience clinical improvement. Hence, in this study we aimed to investigate whether baseline cardiopulmonary exercise testing (CPX) can help improve th...
journal_title:Journal of cardiology
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journal_title:Journal of cardiology
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abstract::The usefulness of 80 degrees head-up tilt testing with and without low dose isoproterenol provocation was evaluated for the diagnosis of neurally mediated syncope (NMS) in Japanese. Head-up tilt testing was performed in 114 consecutive patients with clinical diagnoses of NMS (68 men, 46 women, mean age 46 +/- 21 years...
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journal_title:Journal of cardiology
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pub_type: 杂志文章
doi:10.1016/j.jjcc.2016.05.017
更新日期:2017-04-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:2007-03-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2009.10.005
更新日期:2010-03-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1996-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1988-06-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2016.03.012
更新日期:2017-01-01 00:00:00
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doi:10.1016/j.jjcc.2020.01.013
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pub_type: 杂志文章,评审
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journal_title:Journal of cardiology
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of cardiology
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of cardiology
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更新日期:1996-06-01 00:00:00
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更新日期:2005-06-01 00:00:00
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pub_type: 杂志文章,meta分析
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