Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Infectious Diseases
Volume 2018, Article ID 1951936, 4 pages
https://doi.org/10.1155/2018/1951936
Case Report

Acute Seronegative Toxoplasma gondii Hepatitis Allergic to First-Line Treatment

1Department of Internal Medicine, Christus Muguerza Hospital Alta Especialidad, Universidad de Monterrey, San Pedro Garza García, NL 64060, Mexico
2Department of Gastroenterology, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, NL 64460, Mexico
3Department of Pathology, Christus Muguerza Hospital Alta Especialidad, Universidad de Monterrey, San Pedro Garza García, NL 64060, Mexico
4Epidemiologic Hospital Coordination, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, San Nicolás de los Garza, NL 64460, Mexico

Correspondence should be addressed to Adrián Camacho-Ortiz; moc.oohay@dm_ohcamaca

Received 22 January 2018; Revised 16 February 2018; Accepted 1 March 2018; Published 1 April 2018

Academic Editor: Larry M. Bush

Copyright © 2018 Fernando De la Garza-Salazar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Toxoplasma gondii infects up to one-third of the world’s population, making it the protozoan that most infects people worldwide. Among the forms of presentation of toxoplasmosis, hepatitis is probably the least frequent with only a few case reports in the world’s medical literature. Despite the fact that the first diagnostic test is the serology using the ELISA technique because its sensitivity is close to 100% in our case, it was reported negative. The biopsy gave the definitive diagnosis, and we were able to start treatment immediately. Although the first line of treatment is sulfadiazine and pyrimethamine, our sulfate allergic patient received an alternative regimen of doxycycline, clindamycin, and azithromycin with a good response. This is the only case of Toxoplasma hepatitis reported in Mexico and the only one in the world with negative serology with a good response to second-line treatment.