Fatal disseminated toxoplasmosis in a cardiac transplantation with seropositive match for Toxoplasma:: Should prophylaxis be extended?
Fatal disseminated toxoplasmosis in a cardiac transplantation with seropositive match for Toxoplasma:: Should prophylaxis be extended?
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DOI：
10.1016/j.trim.2007.05.016
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发表时间：
2007-11-01
影响因子：
1.5
通讯作者：
Tanganelli, Piero
中科院分区：
文献类型：
--
作者：
Castagnini, Marta;Bernazzali, Sonia;Tanganelli, Piero
在心脏移植中，免疫功能低下的受者中的弓形虫病可能是由于寄生虫从血清阳性供体（D+）传播到具有移植器官的血清阴性受者（R-）（更常见），或者是由于移植前潜伏感染（D-/R+或D+/R+）的重新激活。在免疫功能低下的病人，弓形虫病是一种危及生命的疾病。我们报告一例播散性弓形虫病心脏移植后，在弓形虫血清阳性受体移植前（R+）（IgG 1：160，IgM阴性）谁收到了器官从弓形虫血清阳性供体（D+）（IgG 1：640，IgM阴性）。未给予抗弓形虫预防性治疗。术后出现了一些并发症，以及肠杆菌和巨细胞病毒（CMV）（再活化）感染，但血清学和组织学弓形虫复发均未得到证实。患者在移植后第41天死亡。尸检后组织学检查显示意外的弥漫性弓形虫病（肺、脑、心脏）。(c)2007 Elsevier B. V.保留所有权利。
In cardiac transplant, toxoplasmosis in the immunocompromised recipient can result either from the transmission of the parasite from a seropositive donor (D+) to a seronegative recipient (R-) with the transplanted organ (more common) or from the reactivation of a pre-transplant latent infection (D-/R+ or D+/R+). In the immunocompromised patient, toxoplasmosis is a life-threatening disease.We report a case of disseminated toxoplasmosis following heart transplantation in a Toxoplasma seropositive recipient before transplantation (R+) (IgG 1:160, IgM negative) who received an organ from a Toxoplasma seropositive donor (D+) (IgG 1:640, IgM negative). No anti-Toxoplasma prophylactic treatment was administered. A number of complications arose in the postoperative period, as well as Enterobacter cloacae and Cytomegalovirus (CMV) (reactivation) infections, but neither serological nor histological toxoplasma recrudescence was evidenced. The patient died on post transplant day 41. Post-autopsy histological examinations revealed an unexpected diffuse toxoplasmosis (lungs, brain, heart). (c) 2007 Elsevier B.V. All rights reserved.