Toxoplasmosis After Hematopoietic Stem Cell Transplantation

Martino, Rodrigo

doi:10.1007/978-3-319-28797-3_42

Cited by 16 publications

(23 citation statements)

References 36 publications

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“…Toxoplasmosis is a devastating opportunistic infection caused by the parasite Toxoplasma gondii, often leading to fatal complications in immunosuppressed stem cell transplanted patients. In an immunocompetent host, contamination results in latency of the parasite as cysts in various organs, whereas in immunocompromised patients infection occurs either by reactivation of latent cysts which is more common in HSCT recipients or as a primary infection, as well . The risk for reactivation is higher for seropositive HSCT recipients receiving a seronegative graft.…”

Section: Introductionmentioning

confidence: 99%

Toxoplasma gondii: How fatal is it in pediatric allogeneic bone marrow transplantation setting?

Komitopoulou

Goussetis

Oikonomopoulou

et al. 2019

Transplant Infectious Dis

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Toxoplasmosis is a disease of the immunocompetent population. However, cases of toxoplasma infection associated with immunosuppression have been reported, especially the first months after transplantation. Limited data are available about toxoplasma infection, occurring even many months post‐transplant in pediatric patients with nonmalignant and malignant diseases. We report the cases of three patients with early and late disseminated toxoplasmosis and review the literature.

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Section: Introductionmentioning

confidence: 99%

Toxoplasma gondii: How fatal is it in pediatric allogeneic bone marrow transplantation setting?

Komitopoulou

Goussetis

Oikonomopoulou

et al. 2019

Transplant Infectious Dis

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“…Whereas the chronic state is typically asymptomatic in immunocompetent adults, the de novo infection or the activation of latent Toxoplasma infection can cause life-threatening disease in immunocompromised hosts (transplacental infection of the human fetus is not addressed in this paper) [1][2][3] . Acute toxoplasmosis has been reported to occur with a frequency of 2-3% in stem cell recipients [4,5] , with very high mortality rates up to 82% [6] .…”

Section: Introductionmentioning

confidence: 99%

Atovaquone for Prophylaxis of Toxoplasmosis after Allogeneic Hematopoietic Stem Cell Transplantation

Mendorf

Klyuchnikov²,

Langebrake³

et al. 2015

Acta Haematol

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Toxoplasmosis and infections by other opportunistic agents such as Pneumocystis jirovecii constitute life-threatening risks for patients after allogeneic hematopoietic stem cell transplantation. Trimethoprim/sulfamethoxazole (TMP-SMX) has been well established for post-transplant toxoplasmosis and pneumocystis prophylaxis, but treatment may be limited due to toxicity. We explored atovaquone as an alternative and compared it with TMP-SMX regarding toxicity and efficacy during the first 100 days after transplantation in 155 consecutive adult stem cell recipients. Eight patients with a prior history of TMP-SMX intolerance received atovaquone as first-line prophylaxis. TMP-SMX was used for 141 patients as first-line strategy, but 13 patients (9.2%) were later switched to atovaquone due to TMP-SMX toxicity or gastrointestinal symptoms. No active toxoplasmosis or active P. jirovecii infection developed under continued prophylaxis with either TMP-SMX or atovaquone. However, for reasons of TMP-SMX and/or atovaquone toxicity, 7 patients were unable to tolerate any efficacious toxoplasmosis prophylaxis and therefore obtained inhalative pentamidine as P. jirovecii prophylaxis but no toxoplasmosis prophylaxis. Importantly, 2 of these patients developed severe toxoplasmosis. In summary, atovaquone appears as a valid alternative for at least some post-transplant patients who cannot tolerate TMP-SMX. This should be further confirmed by multicenter trials.

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“…In contrast to the imaging techniques, our search for specific diseases based on clinical reasoning and serology was more successful [8].…”

Section: Discussionmentioning

confidence: 99%

A fever of unknown origin as a presenting symptom in toxoplasmosis: Back to earth

Mentink¹,

Rijn²,

Dees³

2017

IJCRI

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Toxoplasmosis After Hematopoietic Stem Cell Transplantation

Cited by 16 publications

References 36 publications

Toxoplasma gondii: How fatal is it in pediatric allogeneic bone marrow transplantation setting?

Toxoplasma gondii: How fatal is it in pediatric allogeneic bone marrow transplantation setting?

Atovaquone for Prophylaxis of Toxoplasmosis after Allogeneic Hematopoietic Stem Cell Transplantation

A fever of unknown origin as a presenting symptom in toxoplasmosis: Back to earth

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