December 5, 1966

Four Uncommon Infections In Hodgkin's Disease

JAMA. 1966;198(10):1129. doi:10.1001/jama.1966.03110230145043

To the Editor:  Bacterial, fungal, protozoal, and virus infections develop as examples of altered immunity in patients with malignant lymphomas of the Hodgkin's disease type. A patient with Hodgkin's disease died with herpetic esophagitis, toxoplasmosis of lung and stomach, cytomegalic inclusion disease of lung, and sarcocystis infection of the heart.A 64-year-old white woman was admitted to the University Hospital with a nonproductive cough of two months' duration, weight loss, and fatigue. Physical examination showed hepatosplenomegaly without peripheral lymphadenopathy. Hemoglobin was 10.2 gm/100 ml; hematocrit, 31%; white blood cell count, 6,700/cu mm, with 82% neutrophils. Chest x-ray examination showed faint, rounded densities in the left lower lung field, and laminograms of the chest showed discrete nodular densities in the lower lobes of the lungs. Radiographic films of the abdomen demonstrated hepatic and splenic enlargements.At surgical exploration for acute and chronic cholecystitis and cholelithiasis, the gallbladder was excised, and liver