Toxoplasmic encephalitis associated with meningitis in a heart transplant recipient

Abstract

Toxoplasma gondii is an opportunistic pathogen that causes neurologic and extraneurologic manifestations in immunosuppressed patients. Encephalitis and intracranial mass lesions are easily recognized as typical manifestations of toxoplasmosis. However, meningitis caused by T. gondii is a rare condition with very few cases described in the literature. We present the case of a heart transplant recipient who developed toxoplasmic encephalitis associated with meningitis. After an extensive review of the medical literature, we found only 1 case of meningitis in solid organ transplant recipients and <25 cases in immunosuppressed patients, such as patients infected with human immunodeficiency virus or those with Hodgkin's disease. In this report, we consider toxoplasmosis in the differential diagnosis of meningitis in immunocompromised individuals.

Who let the cats out? A global meta-analysis on risk of parasitic infection in indoor versus outdoor domestic cats (Felis catus)

“…Given that cats are widespread and associated with humans, risk factors for parasitic infections in pet cats are important for zoonotic parasite transmission, with implications for cat health as well as spillover of parasites to sympatric wildlife [11,12]. Domestic pet cats allowed outdoors can also pose health risks to cat owners [13][14][15][16][17][18][19]. For instance, Toxoplasma gondii (the causative agent of toxoplasmosis; [15]) and Bartonella henslae (which causes cat-scratch disease; [17]), both infect people worldwide.…”

Solid Organ Transplant and Parasitic Diseases: A Review of the Clinical Cases in the Last Two Decades

“…One case, after duplicate, was removed, and 36 cases were excluded according to exclusion criteria i (out of scope) and iv (insufficient available data). In the present review we only analyzed cases regarding SOT recipients published from 1996 to 2016 and available on the PubMed database with sufficient data for inclusion on synthesis of results (n 907) [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , ...…”

“…In published and available reviewed literature, we found 162 case reports of toxoplasmosis occurring after SOT [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Of interest, in SOT recipients, toxoplasmosis results more frequently from transmission of the parasite with the transplanted organ from a Toxoplasma -seropositive donor (D+) to a Toxoplasma -seronegative recipient (R−).…”