Diagnosis

Encephalitic symptoms are very contributive for the diagnosis of toxoplasmosis in HIV posi‐ tive patients. Pneumonitis occurring in less than 1% of AIDS cases may induce septic shock. Tissue biopsy should be very important for an early diagnosis

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Cervical or occipital lymphadenopathy are the common clinical feature with flu-like symp‐ toms. Target organs involved are: the brain, the liver, the lung, the muscle, the heart, the eyes, with related symptoms. Pulmonary symptoms may resemble tuberculosis, or severe Pneumocystis jiroveci pneumonia

Reactivation of latent infection is frequent in immunosuppressed patients (AIDS, organ transplantation).

#### *2.3.4. Pulmonary Trypanosomiasis*

Trypanosoma cruzi, the etiological agent of trypanosomiasis is frequent, as Chagas disease, in Central and South America. Man is infected through the bite of an insect, inoculating try‐ pomastigotes which multiply within the macrophages. Macrophages then release amasti‐ gotes, the invading form of tissues through bloodstream. The heart and the gut are the most involved organs with predominant clinical manifestations (myocarditis, arythmia, achalasia, megacolon). Pulmonary manifestations (pleural effusion, edema), are linked to heart in‐ volvement. Tracheomegaly and bronchiectasis have been infrequently encountered (Lemle A. Chagas' disease, Chest 1999; 115, 906). Acute manifestations consist of flu-like syndrome and facial edema.

Serological diagnosis is helpful in chronic forms.
