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Joined: Aug 03, 2012

1. does positive toxoplasmosis test rule out other differential diagnosis like lymphoma?

Posted by @doctormuq, Dec 5, 2012

1. does positive toxoplasmosis test rule out other differential diagnosis like lymphoma? ( I have read that clinical manifestations of toxoplasmosis are rare and occur in children who have cat. and most cases have high IgM about 11or 12 not a low positive ……….
ANSWER….. NO, positive toxoplasmosis test do not rule out other differential diagnosis ABSOLUTLY because Toxoplasmosis can be difficult to distinguish from primary central nervous system lymphoma, and as a result, the diagnosis is made by a trial of therapy (pyrimethamine, sulfadiazine + leucovorin), followed by a brain biopsy if the drugs produce no effect clinically and no improvement .Lymph nodes affected by toxoplasma have characteristic changes, including poorly demarcated reactive germinal centers, clusters of monocytoid B cells and scattered epithelioid histiocytes,THESE CHANGES ARE CHECKED BY BIOPSY……
2. is my lymphadenopathy because of a low positive like2?
ANSWER…… NOT EXACTLY BECAUSE OF LOW IgM …….a clear pathogenesis and commonly accepted defenition, a cutoff for SIgMD`- Isolated primary immunoglobulin M deficiency- could be the lower limit of the serum IgM reference range, such as 43 mg/dL in adults or even 20 mg/dL ,,,,,,,During acute toxoplasmosis, symptoms are often influenza-like: swollen lymph nodes, or muscle aches and pains that last for a month or more. Rarely, a patient with a fully functioning immune system may develop eye damage from toxoplasmosis. Young children and immunocompromised patients, such as those with HIV/AIDS, those taking certain types of chemotherapy, or those who have recently received an organ transplant, may develop severe toxoplasmosis. This can cause damage to the brain (encephalitis) or the eyes (necrotizing retinochoroiditis)IN EXTREME PHASE. Infants infected via placental transmission may be born with either of these problems, or with nasal malformations, although these complications are rare in newborns.

Swollen lymph nodes are commonly found in the neck or under the chin, followed by the axillae and the groin. Swelling may occur at different times after the initial infection, persist, and/or recur for various times independently of antiparasitic treatment. It is usually found at single sites in adults, but in children multiple sites may be more common. Enlarged lymph nodes will resolve within one to two months in 60% of patients. However, a quarter of patients take 2–4 months to return to normal and 8% take 4–6 months. A substantial number of patients (6%) do not return to normal until much later.
3. is biopsy necessary?
ANSWER…..According to my opinion biopsy is necessary in a case that if the trial of therapy (pyrimethamine, sulfadiazine + leucovorin), FAILS……….. @barankia40


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