Infectious Agents
Case 3

Clinical Features
Light Microsocopy
Electron Microscopy
Discussion

Case 1
Case 2
Case 3
Case 4

Electron Microscopy of Infectious Agents

Case 3: Toxoplasma Encephalitis

Clinical Features

The fifteen year old male patient experienced weight loss and jaundice over the two months following bone marrow transplant from a histocompatible sister, and returned to hospital with a low grade fever and moderate hepatosplenomegaly.

Laboratory tests suggested hepatitis due to graft-versus-host disease.

In the hospital he developed a retroorbital headache. Following a splenectomy and liver biopsy the patient became restless and uncoordinated. Vesicular lesions developed on the chest wall and were positive for Tzanck cells. Acyclovir treatment was begun because of concern for varicella-zoster encephalitis. The next day he complained of worse headaches and photophobia, became disoriented, developed a 39 degree C fever, and had a tonic-clonic seizure in the left arm and face followed by paresis and numbness.

A CT study of the brain with contrast demonstrated multiple low attenuation lesions in the right cerebral hemisphere with faint rim enhancement.

Light Microscopy