RESUMEN
INTRODUCTION: Good syndrome is a rare condition in which thymoma is associated with hypogammaglobulinemia. It is characterized by an increased susceptibility to infections. CASE REPORT: We report a woman with Good's syndrome diagnosed after severe congenital toxoplasmosis in her daughter, even though she was immunized against this infection during pregnancy. CONCLUSION: This presentation is very unusual by its early diagnosis and to our knowledge is the first report of parasitic infection in this syndrome.
Asunto(s)
Síndromes de Inmunodeficiencia/complicaciones , Complicaciones Parasitarias del Embarazo/etiología , Timoma/complicaciones , Neoplasias del Timo/complicaciones , Toxoplasma/fisiología , Toxoplasmosis Congénita/etiología , Toxoplasmosis/transmisión , Adulto , Femenino , Humanos , Síndromes de Inmunodeficiencia/parasitología , Recién Nacido , Embarazo , Complicaciones Parasitarias del Embarazo/inmunología , Enfermedades Raras , Índice de Severidad de la Enfermedad , Timoma/inmunología , Timoma/parasitología , Neoplasias del Timo/inmunología , Neoplasias del Timo/parasitología , Toxoplasma/inmunología , Toxoplasmosis/complicaciones , Toxoplasmosis/inmunología , Toxoplasmosis Congénita/inmunología , VacunaciónRESUMEN
Opportunistic isosporidial infection of the gastrointestinal tract is frequently encountered in patients with acquired immunodeficiency syndrome (AIDS) and is considered to be an AIDS-defining illness. Chronic severe watery diarrhea due to Isospora belli has also been reported in other immunodeficiency states. This report describes severe chronic debilitating diarrhea due to isosporiasis in a patient with mediastinal thymoma, a common tumor of the anterior mediastinum, originating from the epithelial cells of the thymus. Numerous oocysts of I. belli were detected in direct smear preparation of the diarrheic stool sample of the patient, who had an 8-month history of recurrent diarrhea. Duodenal and colonic mucosal biopsies revealed slight degrees of atrophic changes associated with infiltration of the lamina propria by an appreciable number of eosinophiles and the presence of unizoit tissue cysts of I. belli in the surface epithelium of the duodenal mucosa. The patient was first treated with trimethoprim-sulfamethoxazole and subsequently underwent complete thymectomy. Later, due to recurrence of the diarrhea, he was treated with ciprofloxacin.