Pulmonary toxoplasmosis.

With the advent of the human immunodeficiency virus (HIV) epidemic, the worldwide incidence of infections caused by Toxoplasma gondii has been rising. In this article I discuss the pathophysiology, diagnosis, and treatment of toxoplasma pneumonia. Basic research is now directed at the relationship of this organism to its host cells and how pharmacological or immunologic manipulation of that relationship may treat or prevent primary or recurrent infection. In addition to the standard diagnostic methods for T. gondii infection, newer methods using the tools of molecular genetics and immune complex staining are discussed. Although it is known that standard therapy for T. gondii pneumonia should use the synergistic combination of pyrimethamine and a sulfa-based antibiotic, optimal prophylactic antibiotic combinations and dosing schedules for recurrent infection are still being investigated. By stressing primary prevention and appropriate prophylaxis against T. gondii infection, the incidence of toxoplasma pneumonia in the immunocompromised host may be minimized.