Toxoplasma Appendicitis: A Once-in-a-Lifetime Diagnosis

Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were...

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Bibliographic Details
Published in:International journal of surgical pathology 2018-02, Vol.26 (1), p.89-92
Main Authors: Fernandes, Anisha M., Lakhe, Maheshkumar M., Pai, Sanjay A.
Format: Article
Language:English
Subjects:
Appendicitis
Appendicitis - microbiology
Humans
Immunocompromised Host
Immunosuppressive Agents - therapeutic use
Male
Methotrexate - therapeutic use
Middle Aged
Psoriasis - drug therapy
Toxoplasmosis - immunology
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Summary:Toxoplasmosis is generally asymptomatic in immunocompetent individuals, but it can be life-threatening in immunocompromised patients. We present a case of a 62-year-old man with clinical features of acute appendicitis. Histology showed a transmural infiltrate of eosinophils. In addition, there were reactive lymphoid follicles with histiocytes in the submucosa and tachyzoites in the muscularis propria. Immunohistochemistry confirmed the diagnosis of toxoplasma appendicitis. Serological evaluation yielded negative results. Retrospective review of the history revealed that the patient was on long-term immunosuppressive therapy with methotrexate. The patient was treated with sulfamethoxazole-trimethoprim and is asymptomatic at 7-month follow-up. Toxoplasma appendicitis must be considered in the differential diagnosis of appendicitis in immunosuppressed patients.
ISSN:1066-8969
1940-2465
DOI:10.1177/1066896917724888