Extreme Elevations of Serum Lactic Dehydrogenase Differentiating Pulmonary Toxoplasmosis from Pneumocystis Pneumonia

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Abstract
Toxoplasma gondii usually causes cerebral abscesses in immunocompromised patients, particularly those with the acquired immunodeficiency syndrome (AIDS).1 Toxoplasmosis may also take a disseminated form, with dominant pulmonary involvement.2 Patients with this illness present with fever, cough, and dyspnea and have diffuse infiltrates on chest roentgenography, as do patients with Pneumocystis carinii pneumonia. Their mortality, however, is much higher and has exceeded 75 percent. The diagnosis is often made only at autopsy, but bronchoalveolar lavage may reveal the presence of toxoplasma on staining with conventional (Giemsa) or more specific (monoclonal antibody3) agents.