Diagnostic Pitfalls: Toxoplasmosis Misdiagnosed as Dengue Leading to Severe Ocular Complications
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Purpose
To describe two cases of acute toxoplasmosis misdiagnosed as dengue, highlighting the clinical similarities between the two diseases, the importance of differential diagnosis, and the need for timely treatment to prevent severe ocular complications.
Methods
Case Report
Results
Two patients with systemic symptoms initially suggestive of dengue were diagnosed clinically without confirmatory testing. Both patients did not receive treatment for toxoplasmosis. After approximately 2.5 months, they presented with ocular symptoms, including reduced visual acuity. Ophthalmological examinations revealed macular retinochoroiditis lesions. Serological testing confirmed acute toxoplasmosis with positive IgM and IgG antibodies. Treatment led to clinical improvement; however, both patients developed permanent macular scars resulting in
significant visual impairment, with final visual acuities of 20/200 and 20/100. The delayed diagnosis and treatment of toxoplasmosis during its acute phase likely contributed to the development of these irreversible ocular lesions.
Conclusion
These cases underscore the clinical overlap between dengue and toxoplasmosis, emphasizing the critical need for thorough differential diagnostic protocols, particularly in regions endemic
to both diseases. Timely serological testing and early intervention for toxoplasmosis can prevent severe ocular complications and permanent visual impairment. Increased clinical awareness and diagnostic rigor are essential to improving patient outcomes in similar cases.
Conflict of interest
No
1
Last name
ZANETTI PATRICIO DE MACEDO
Initials of first name(s)
B
Department
Clínica Moacir Cunha/ Grupo Fleury
City
São Paulo
Country
Brazil
2
Last name
ANDRADE
Initials of first name(s)
G
Department
Clínica Moacir Cunha/ Grupo Fleury
City
São Paulo
Country
Brazil
3
Last name
Cunha
Initials of first name(s)
L
Department
Clínica Moacir Cunha/ Grupo Fleury
City
São Paulo
Country
Brazil
4
Last name
Oliveira
Initials of first name(s)
L.B.
Department
Clínica Moacir Cunha/ Grupo Fleury
City
São Paulo
Country
Brazil
5
Last name
Finamor
Initials of first name(s)
L
Department
Clínica Moacir Cunha/ Grupo Fleury
City
São Paulo
Country
Brazil
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