Toxoplasmosis. Problems in diagnosis and treatment.

Forty-two cases of Toxoplasma gondii infection were analyzed, 25 in patients with neoplastic disease and 17 in apparently normal patients. Infection in normal hosts was usually manifested by adenopathy and ran a benign course. Infection in patients with neoplastic diseases was usually manifested by fever and/or neurologic symptoms. Patients with leukemias and lymphomas, particularly Hodgkin's Disease, were at highest risk for infection. Most, but not all, patients developed serologic titers indicative of infection. T. gondii infections were fatal in all eight cases with central nervous system involvement despite treatment in five cases. Leukopenia was a significant complication of treatment with sulfadiazine and pyrimethamine despite the use of folinic acid.