To the Editor.—
We describe a heroin addict with the acquired immunodeficiency syndrome (AIDS) who developed fever, hepatosplenomegaly, weight loss, and a nonpruritic eruption of erythematous blanching papules on the face, trunk, and extremities, sparing the palms and soles. A bone marrow biopsy demonstrated tachyzoites of Toxoplasmosis gondii, establishing the diagnosis of disseminated toxoplasmosis, and the eruption resolved with treatment for this infection. Skin lesions with toxoplasmosis are very uncommon in immunocompetent or immunocompromised adults and have not been previously described in patients with AIDS, even though they commonly have infection in the brain with this organism.
Report of a Case.—
A 27-year-old male heroin addict from Italy had fever, anorexia, and weight loss of 25 kg for two months and a widespread, nonpruritic eruption for six days. He was wasted, pallid, and febrile. There were numerous, 0.5- to 1-cm, red, blanching, nontender papules on his face, trunk, legs, and arms,