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Disseminated toxoplasmosis in non-allografted patients with hematologic malignancies: report of two cases and literature review.
MedLine Citation:
PMID:  23595587     Owner:  NLM     Status:  Publisher    
Toxoplasmosis can be a severe opportunistic infection in patients with acquired immunodeficiency syndrome (AIDS), and also among solid organ transplant and allogeneic hematopoietic stem cell transplant (HSCT) patients. Patients with low-grade or chronic hematologic malignancies are treated with increasing immunosuppressive regimens and, therefore, represent an emerging population at risk for opportunistic diseases. We report here two cases of disseminated toxoplasmosis occurring in non-allografted hematologic patients with chronic lymphoproliferations. A review of 44 cases from the literature reveals that toxoplasmosis occurs increasingly in indolent B cell lymphoproliferative disorders. Aggressive lymphoproliferations, adenosine analogs, autologous HSCT, and the absence of chemoprophylaxis are the main risk factors for opportunistic toxoplasmosis. The central nervous system is the main organ involved. Fever is only present in half of all cases. Latent Toxoplasma cysts reactivation (LTCR) is the most common, but primary infection occurs in about 20 % of cases. Global mortality is over 50 %.
S Scerra; H Coignard-Biehler; F Lanternier; F Suarez; C Charlier-Woerther; M-E Bougnoux; J Gilquin; M Lecuit; O Hermine; O Lortholary
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-18
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  -     ISSN:  1435-4373     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker Pasteur, Université Paris Descartes, Hôpital Necker-Enfants Malades, APHP, 149, rue de Sèvres, 75015, Paris, France.
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