Diagnosis of Toxoplasmosis after Allogeneic Stem Cell Transplantation: Results of DNA Detection and Serological Techniques

Abstract

Thus, after HSCT, all patients were at risk for toxoplasmosis; all patients who receive HSCTs should be followed up with biological testing that combines PCR and serological techniques.

Febrile pancytopenia as uncommon presentation of disseminated toxoplasmosis after BMT

“…Moreover, the development of DNA-based diagnostic methods has greatly improved the sensitivity of the biological diagnosis, but reports of toxoplasmosis cases with negative T.gondii PCR in plasma are not rare. 5 In our case, first negative PCR results in serum and CSF were misleading. Diagnosis of definite disseminated toxoplasmosis was obtained secondarily thanks to the observation of tachyzoites by microscopic examination of Giemsa-stained smears of BM, associated with the late positivity of T.gondii PCR in CSF and plasma.…”

Toxoplasmosis and allogeneic stem cell transplantation: can we do better?

“…PCR can also be performed as part of routine monitoring for reactivation, on a weekly blood test, as a tool to guide early therapy for toxoplasmosis. Blood usually becomes positive at or before the onset of tissue invasive disease, allowing early antibiotic therapy [6,10]. Such an approach appears to have reduced mortality from toxoplasmosis in the prospective study of Martino et al, although the number of cases of disease in this study was small [6].…”

“…Increasing parasite load measured by PCR appears to correlate with development of disease [6]. Several authors recommend this screening approach [4,10] whilst the American Society for Blood and Marrow Transplantation guidelines for preventing infection after SCT [11] recommend screening or prophylaxis for patients at high risk of toxoplasmosis. Better defining the duration of risk and the duration of treatment or prophylaxis needed for toxoplasmosis as well as the kinetics of immune reconstitution to T. gondii after allo-SCT is an area for future research.…”

Serological monitoring of a Toxoplasma infection after hematopoietic stem cell transplantation

“…Toxoplasmosis is a rare but serious complication in allogeneic HSCT recipients 3,5,7,8,10 . Most cases of Toxoplasma infections occur in seropositive HSCT recipients, suggesting that toxoplasmosis usually results from the reactivation of latent tissue parasites 5,8 .…”

“…The early detection of T. gondii DNA in body fluids by PCR methods has been considered an important tool for monitoring Toxoplasma infection following HSCT 5,6 . A recent study has shown the importance of monitoring toxoplasmosis after HSCT with biological tests that combine PCR and serological techniques 3 . This case stresses the importance of detecting anti-T. gondii antibodies in donors and recipients before transplantation, and of serologically monitoring the recipient during long-term follow-up.…”