Opportunistic Infections of the Central Nervous System in the Transplant Patient

Cohen, Bruce A.; Stosor, Valentina

doi:10.1007/s11910-013-0376-x

Cited by 15 publications

(18 citation statements)

References 116 publications

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“…2,3 Toxoplasmosis is one of the most important infectious agents in immunocompromised patients. 4,5 The infection usually occurs by consuming undercooked meat containing Toxoplasma gondii tissue cysts or drinking contaminated water with oocysts shed in the feces of cats. 6 In transplant recipient individuals, the infection usually transmitted from a Toxoplasma-seropositive donor to a Toxoplasma-seronegative recipient.…”

Section: Introductionmentioning

confidence: 99%

Serological and molecular survey of toxoplasmosis in renal transplant recipients and hemodialysis patients in Kashan and Qom regions, central Iran

et al. 2016

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Toxoplasma gondii is one of the important opportunistic pathogen among solid-organ transplant recipients and hemodialysis patients (HD). This study was aimed to detect toxoplasmosis among 50 renal transplant recipients (RTR), 135 HD and 120 healthy individuals in two cities (Kashan and Qom) that located in the center of Iran, from 2014 to 2015. Serological detection (IgG and IgM antibodies) was performed among all individuals in case and control groups. Molecular detection was performed on all IgM positive individuals or IgG positive with moderate to high (>51 IU/mL) antibody titers in HD (n ¼ 42) and control groups (n ¼ 21). In RTR patients, molecular detection was conducted among all seropositive or seronegative individuals (n ¼ 50). IgG seropositivity was detected in 52% (26/50) of RTR, 63% (85/135) of HD and 33.3% (40/120) of the control group. The rate of anti-T. gondii IgG antibody was significantly elevated in RTR and HD patients than the control group (p ¼ 0.023 and p < 0.001, respectively). IgM seropositivity was only detected in one HD patient. T. gondii DNA was detected in 12% (6/50) of RTR and 7.1% (3/42) of HD patients. The results of this study suggested that the screening of toxoplasmosis should be given greater consideration among RTR and hemodialysis patients. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 99%

Serological and molecular survey of toxoplasmosis in renal transplant recipients and hemodialysis patients in Kashan and Qom regions, central Iran

et al. 2016

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“…Neuroimaging features may contribute to the diagnosis 10 . Table 2 describes, in detail, the main infections associated with solid organ transplantation patients 11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28 .…”

Section: Differential Diagnosis Of Infection In Solid Organ Causativementioning

confidence: 99%

“…Cranial neuropathies, dysarthria, paresis, and ataxia occur in approximately 40% due to brainstem involvement (rhombencephalitis) 10,22 . CSF analysis usually demonstrates polymorphonuclear or lymphocytic pleocytosis with elevated protein levels, and hypoglycorrhachia.…”

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Neurological complications of solid organ transplantation

Pedroso

Dutra

Braga‐Neto

et al. 2017

Arq. Neuro-Psiquiatr.

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Solid organ transplantation is a significant development in the treatment of chronic kidney, liver, heart and lung diseases. This therapeutic approach has increased patient survival and improved quality of life. New surgical techniques and immunosuppressive drugs have been developed to achieve better outcomes. However, the variety of neurological complications following solid organ transplantation is broad and carries prognostic significance. Patients may have involvement of the central or peripheral nervous system due to multiple causes that can vary depending on time of onset after the surgical procedure, the transplanted organ, and the intensity and type of immunosuppressive therapy. Neurological manifestations following solid organ transplantation pose a diagnostic challenge to medical specialists despite extensive investigation. This review aimed to provide a practical approach to help neurologists and clinicians assess and manage solid organ transplant patients presenting with acute or chronic neurological manifestations.Keywords: organ transplantation; neurological manifestations; central nervous system; peripheral nervous system. RESUMO O transplante de órgãos sólidos é um importante avanço no tratamento de doenças crônicas renal, hepática e cardíaca. Esta terapia tem aumentado a sobrevida e melhorado a qualidade de vida dos pacientes. Novas técnicas cirúrgicas e imunossupressores tem sido desenvolvidos para alcançar melhores desfechos. Entretanto, a variedade de complicações neurológicas que acompanham o transplante de órgãos sólidos é ampla, e carrega significado prognóstico. Pacientes podem ter acometimento do sistema nervoso central ou periférico devido a múltiplas causas que podem variar conforme o tempo após a realização da cirurgia, órgão transplantado e grau e tipo de terapia de imunossupressão. Manifestações neurológicas após o transplante de órgãos sólidos representam um desafio diagnóstico para médicos especialistas apesar de extensa investigação. O objetivo desta revisão é oferecer uma abordagem prática para ajudar neurologistas e clínicos a avaliar e manejar pacientes com transplante de órgãos sólidos que se apresentem com manifestações neurológicas agudas ou crônicas.Palavras-chave: transplante de órgãos; manifestações neurológicas; sistema nervoso central; sistema nervoso periférico.

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“…The prevalence of opportunistic CNS infections following SOT has been historically estimated at 5-10 % of transplant recipients [23], although many recent studies report only 1-2 % of patients with CNS infections which is probably attributable to better prophylaxis, and improved diagnostic and treatment protocols [5][6][7][8]. Diagnosis of CNS infections in immunosuppressed patients may be delayed because of the diminished ability to mount an inflammatory response.…”

Section: Opportunistic Infectionsmentioning

confidence: 99%

The Neurology of Solid Organ Transplantation

Avila

Živković

2015

Curr Neurol Neurosci Rep

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Transplantation is the rescue treatment for end-stage organ failure with more than 110,000 solid organs transplantations performed worldwide annually. Recent advances in transplantation procedures and posttransplantation management have improved long-term survival and quality of life of transplant recipients, shifting the focus from acute perioperative critical care needs toward long-term chronic medical problems. Neurologic complications affect up to 30-60 % of solid organ transplant recipients. Common etiologies include opportunistic infections and toxicities of antirejection medications, and wide spectrum of toxic and metabolic disturbances. Most complications are common to all allograft types, but some are relatively specific for individual allograft types (e.g., central pontine myelinolysis in liver transplant recipients). Close collaboration between neurologists and other transplant team members is essential for effective management. Early recognition of complications and accurate diagnosis leading to timely treatment is essential to reduce the morbidity and improve the overall transplant outcome.

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Opportunistic Infections of the Central Nervous System in the Transplant Patient

Cited by 15 publications

References 116 publications

Serological and molecular survey of toxoplasmosis in renal transplant recipients and hemodialysis patients in Kashan and Qom regions, central Iran

Serological and molecular survey of toxoplasmosis in renal transplant recipients and hemodialysis patients in Kashan and Qom regions, central Iran

Neurological complications of solid organ transplantation

The Neurology of Solid Organ Transplantation

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