Hemophagocytic Syndrome as Uncommon Presentation of Disseminated Toxoplasmosis in an Immunocompetent Adult from Chinese Kunming

Abstract

Abstract. Hemophagocytic syndrome is a rare disease that is often fatal, despite treatment. An immunocompetent patient was presented with fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia, which conformed to a hemophagocytic syndrome diagnosis. Despite broad antibiotic treatment, the patient's clinical condition rapidly deteriorated and he died within 8 days of admission. Blood cultures and a serology test were negative; however, based on morphological characteristics, tissue cysts Toxoplasma gondii were found in the bone marrow. Based on polymerase chain reaction analysis, identity of the parasite was confirmed. Although very rare, T. gondii-associated hemophagocytic syndrome should be suspected in the case of cytopenia or multiorgan failure symptoms. To our knowledge, this is the first fatal toxoplasmosis case reported from China.

Disseminated Toxoplasmosis associated with Haemophagocytic Lymphohistiocytosis in a Patient with the Human Immunodeficiency Virus: A Case Report and Literature Review

“…To our knowledge, only eight cases of DT-HLH have been reported in the literature so far (Supplementary Table 1) (Blanche et al, 1994;Guillaume et al, 2006;Segall et al, 2006;Duband et al, 2008;Yang et al, 2013;Gay et al, 2019;Kator et al, 2020;Sanchez-Petitto et al, 2020). The mean age of the previously reported patients was 39 years (range, 25-59 years); 88% were male.…”

Disseminated toxoplasmosis associated with hemophagocytic syndrome after kidney transplantation: A case report and review

“…Among the parasitic and fungal infections, babesiosis, leishmaniosis, toxoplasmosis, malaria, strongyloidiasis, and pneumocystis agents were reported to be associated with HPS . Between 1994 and 2018, 17 cases in the literature described toxoplasmosis associated with HPS mostly in immunodeficient patients, including 10 HIV‐infected patients, 1 bone marrow transplant patient, 5 kidney transplant patients, and 2 immunocompetent patients . The rare association between disseminated toxoplasmosis and HPS in kidney recipients is only described in 5 cases with a mortality rate of 60%, including one reactivation case (Table ).…”