{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T22:22:05Z","timestamp":1790461325771,"version":"4.1.0"},"reference-count":38,"publisher":"FapUNIFESP (SciELO)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Inst. Med. trop. S. Paulo"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:p>We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.<\/jats:p>","DOI":"10.1590\/s0036-46652010000200008","type":"journal-article","created":{"date-parts":[[2010,4,29]],"date-time":"2010-04-29T09:43:17Z","timestamp":1272534197000},"page":"107-110","source":"Crossref","is-referenced-by-count":25,"title":["Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon"],"prefix":"10.1590","volume":"52","author":[{"given":"Juan","family":"Nunura","sequence":"first","affiliation":[{"name":"Ministerio de Salud, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"V\u00e1squez","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Endo","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Salazar","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandrina","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Pereyra","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Salud del Ni\u00f1o, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilda","family":"Solis","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos, Per\u00fa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.3201\/eid0901.020160","article-title":"Highly endemic, waterborne toxoplasmosis in north Rio de Janeiro State, Brazil","volume":"9","author":"Bahia-Oliveira LM","year":"2003","journal-title":"Emerg Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1080-6040","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1590\/S0036-46652008000100004","article-title":"Seroprevalence of Toxoplasma gondii infection among indian people living in Lauaret\u00e9, S\u00e3o Gabriel da Cachoeira, Amazonas, Brazil","volume":"50","author":"Boia M","year":"2008","journal-title":"Rev Inst Med Trop Sao Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0036-4665","issn-type":"print"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1080\/08820530500231961","article-title":"Toxoplasmosis","volume":"20","author":"Bonfioli A","year":"2005","journal-title":"Semin Ophthalmol","ISSN":"https:\/\/id.crossref.org\/issn\/0882-0538","issn-type":"print"},{"issue":"9072","key":"ref4","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S0140-6736(96)11105-3","article-title":"Outbreak of toxoplasmosis associated with municipal drinking water: The BC Toxoplasma Investigation Team","volume":"350","author":"Bowie WR","year":"1997","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"4037","DOI":"10.1128\/JCM.40.11.4037-4044.2002","article-title":"Severe acquired toxoplasmosis in immunocompetent adult patients in French Guiana","volume":"40","author":"Carme B","year":"2002","journal-title":"J Clin Microbiol","ISSN":"https:\/\/id.crossref.org\/issn\/0095-1137","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"656","DOI":"10.3201\/eid1504.081306","article-title":"Severe acquired toxoplasmosis caused by wild cycle of Toxoplasma gondii, French Guiana","volume":"15","author":"Carme B","year":"2009","journal-title":"Emerg Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1080-6040","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1051\/parasite\/2008153366","article-title":"Toxoplasma gondii, \"new\" genotypes and virulence","volume":"15","author":"Darde ML","year":"2008","journal-title":"Parasite","ISSN":"https:\/\/id.crossref.org\/issn\/1252-607X","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/S0140-6736(04)16841-4","article-title":"Severe acute disseminated toxoplasmosis","volume":"364","author":"Darde M","year":"2004","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1016\/j.jinf.2005.10.026","article-title":"Severe pneumonia during primary infection with an atypical strain of Toxoplasma gondii in an immunocompetent young man","volume":"53","author":"De Salvador-Guillou\u00ebt F","year":"2006","journal-title":"J Infect","ISSN":"https:\/\/id.crossref.org\/issn\/0163-4453","issn-type":"print"},{"key":"ref10","first-page":"402","article-title":"Infectious hazards in military personnel in operations","volume":"26","author":"Debord T","year":"1996","journal-title":"Med Mal Infect","ISSN":"https:\/\/id.crossref.org\/issn\/0399-077X","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"195","DOI":"10.4269\/ajtmh.2008.78.195","article-title":"Atypical Toxoplasma gondii strain from a free-living jaguar (Panthera onca) in French Guiana","volume":"78","author":"Demar M","year":"2008","journal-title":"Am J Trop Med Hyg","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1086\/597235","article-title":"Outbreak of Pseudomonas aeruginosa infection associated with contamination of a flexible bronchoscope","volume":"30","author":"Diaz Granados CA","year":"2009","journal-title":"Infect Control Hosp Epidemiol","ISSN":"https:\/\/id.crossref.org\/issn\/0899-823X","issn-type":"print"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1590\/S0036-46652009000100003","article-title":"Seroepidemiology of toxoplasmosis in women of childbearing age from a marginal community of Maracaibo, Venezuela","volume":"51","author":"Diaz-Suarez O","year":"2009","journal-title":"Rev Inst Med Trop Sao Paulo","ISSN":"https:\/\/id.crossref.org\/issn\/0036-4665","issn-type":"print"},{"key":"ref14","first-page":"260","article-title":"Toxoplasmic hepatitis in an immunocompetent patient","volume":"31","author":"Dogan N","year":"2007","journal-title":"T\u00fcrk Parazitol Dergisi"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.exppara.2005.09.010","article-title":"Toxoplasma gondii: serological recognition of reinfection","volume":"112","author":"Dzitko K","year":"2006","journal-title":"Exp Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0014-4894","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4269\/ajtmh.2009.81.171","article-title":"A community-based survey of human toxoplasmosis in rural Amazonia: seroprevalence, seroconversion rate, and associated risk factors","volume":"81","author":"Ferreira MU","year":"2009","journal-title":"Am J Trop Med Hyg","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9637","issn-type":"print"},{"key":"ref17","first-page":"65","article-title":"Impact of stage differentiation on diagnosis of toxoplasmosis","volume":"40","author":"Gross U","year":"2004","journal-title":"Ann Ist Super Sanit\u00e0"},{"key":"ref18","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1086\/317486","article-title":"Pseudomonas aeruginosa community-acquired pneumonia in previously healthy adults: case report and review of the literature","volume":"31","author":"Hatchette T","year":"2000","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.jbspin.2007.08.009","article-title":"Acute acquired toxoplasmosis presenting as polymyositis and chorioretinitis in immunocompetent patient","volume":"75","author":"Hassene A","year":"2008","journal-title":"Joint Bone Spine"},{"key":"ref20","first-page":"1","article-title":"Ocular toxoplasmosis: a global reassessment: Part II: Disease manifestation and management","volume":"137","author":"Holland G","year":"2004","journal-title":"Am J Opthalmol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"5878","DOI":"10.4049\/jimmunol.166.10.5878","article-title":"Cutting edge: systemic inhibition of angiogenesis underlies resistance to tumors during acute toxoplasmosis","volume":"166","author":"Hunter C","year":"2001","journal-title":"J Immunol","ISSN":"https:\/\/id.crossref.org\/issn\/0022-1767","issn-type":"print"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.exppara.2009.03.013","article-title":"Waterborne toxoplasmosis: recent developments","volume":"124","author":"Jones JL","year":"2010","journal-title":"Exp Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0014-4894","issn-type":"print"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1111\/j.1469-0691.2006.01564.x","article-title":"Evaluation of a commercial IgE ELISA in comparison with IgA and IgM ELISAs, IgG avidity assay and complement fixation for the diagnosis of acute toxoplasmosis","volume":"13","author":"Kodym P","year":"2007","journal-title":"Clin Microbiol Infect"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1086\/511871","article-title":"Toxoplasma gondii pneumonia in immunocompetent sbjects: case report and review","volume":"44","author":"Leal F","year":"2007","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"11423","DOI":"10.1073\/pnas.0601438103","article-title":"Globalization and the population structure of Toxoplasma gondii","volume":"103","author":"Lehmann T","year":"2006","journal-title":"Proc Natl Acad Sci USA","ISSN":"https:\/\/id.crossref.org\/issn\/0027-8424","issn-type":"print"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"14","DOI":"10.20453\/rmh.v9i1.564","article-title":"Toxoplasmosis en Bartonellosis humana","volume":"9","author":"Magui\u00f1a C","year":"1998","journal-title":"Rev Med Hered"},{"key":"ref27","first-page":"374696","article-title":"Does Toxoplasma gondii infection affect the levels of IgE and cytokines (IL-5, IL-6, IL-10, IL-12, and TNF-alpha)?","author":"Matowicka-Karna J","year":"2009","journal-title":"Clin Dev Immunol"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1965","DOI":"10.1016\/S0140-6736(04)16412-X","article-title":"Toxoplasmosis","volume":"363","author":"Montoya J","year":"2004","journal-title":"Lancet","ISSN":"https:\/\/id.crossref.org\/issn\/0099-5355","issn-type":"print"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/clind\/24.4.676","article-title":"Toxoplasmic myocarditis and polymyositis in patients with acute acquired toxoplasmosis diagnosed during life","volume":"24","author":"Montoya J","year":"1997","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1128\/CMR.00001-08","article-title":"Bacterial, fungal, parasitic, and viral myositis","volume":"21","author":"Nancy FCC","year":"2008","journal-title":"Clin Microbiol Rev","ISSN":"https:\/\/id.crossref.org\/issn\/0893-8512","issn-type":"print"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/1471-2474-2-8","article-title":"Polyomyositis and myocarditis associated with acquired toxoplasmosis in an immunocompetent girl","volume":"2","author":"Paspalaki P","year":"2001","journal-title":"BMC Musculoskelet Disord"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1016\/j.ijpara.2007.09.004","article-title":"Population structure and mouse-virulence of Toxoplasma gondii in Brazil","volume":"38","author":"Pena HF","year":"2008","journal-title":"Int J Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0020-7519","issn-type":"print"},{"key":"ref33","first-page":"603","article-title":"Ocular toxoplasmosis","volume":"104","author":"Pleyer U","year":"2007","journal-title":"Ophthalmologe","ISSN":"https:\/\/id.crossref.org\/issn\/0941-293X","issn-type":"print"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1093\/clinids\/14.4.863","article-title":"Pulmonary toxoplasmosis: a review","volume":"14","author":"Pomeroy C","year":"1992","journal-title":"Clin Infect Dis","ISSN":"https:\/\/id.crossref.org\/issn\/1058-4838","issn-type":"print"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.vetpar.2009.01.017","article-title":"Prevalence of anti-Toxoplasma gondii antibodies in dairy cattle, dogs, and humans from the Jauru micro-region, Mato Grosso State, Brazil","volume":"161","author":"Santos TR","year":"2009","journal-title":"Vet Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0304-4017","issn-type":"print"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1056\/NEJMoa021808","article-title":"An Outbreak of Pseudomonas aeruginosa infections associated with flexible bronchoscopes","volume":"348","author":"Srinivasan A","year":"2003","journal-title":"N Engl J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/S0020-7519(00)00124-7","article-title":"Toxoplasma gondii: from animals to humans","volume":"30","author":"Tenter A","year":"2000","journal-title":"Int J Parasitol","ISSN":"https:\/\/id.crossref.org\/issn\/0020-7519","issn-type":"print"},{"key":"ref38","first-page":"521","article-title":"Skeletal muscle pathology in mice experimentally infected with Toxoplasma gondii","volume":"28","author":"Tonino P","year":"1996","journal-title":"J Submicrosc Cytol Pathol","ISSN":"https:\/\/id.crossref.org\/issn\/0022-4782","issn-type":"print"}],"container-title":["Revista do Instituto de Medicina Tropical de S\u00e3o Paulo"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/rimtsp\/v52n2\/08.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,28]],"date-time":"2019-05-28T21:04:03Z","timestamp":1559077443000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0036-46652010000200008&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4]]},"references-count":38,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2010,4]]}},"alternative-id":["S0036-46652010000200008"],"URL":"https:\/\/doi.org\/10.1590\/s0036-46652010000200008","relation":{},"ISSN":["0036-4665"],"issn-type":[{"value":"0036-4665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,4]]}}}