Toxoplasmosis, a Severe Complication in Allogeneic Hematopoietic Stem Cell Transplantation: Successful Treatment Strategies during a 5-Year Single-Center Experience
Toxoplasmosis is a rare but often fatal complication that occurs after patients undergo allogeneic hematopoietic stem cell transplant. At our institution, toxoplasmosis was diagnosed in 8 of 301 patients who received stem cell transplants. Disseminated toxoplasmosis with a rapid fatal course was obs...
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| Veröffentlicht in: | Clinical infectious diseases 2001-01, Vol.32 (1), p.e1-e8 |
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| creator | Roemer, E. Blau, I. W. Basara, N. Kiehl, M. G. Bischoff, M. Günzelmann, S. Kirsten, D. Sanchez, H. Wocker, E. L. Fauser, A. A. |
| description | Toxoplasmosis is a rare but often fatal complication that occurs after patients undergo allogeneic hematopoietic stem cell transplant. At our institution, toxoplasmosis was diagnosed in 8 of 301 patients who received stem cell transplants. Disseminated toxoplasmosis with a rapid fatal course was observed in 2 patients. Six patients had cerebral toxoplasmosis diagnosed on the basis of neurological signs and observation of the patients' mental confusion, seizures, and typical lesions (which were assessed by computed tomography, magnetic resonance imaging, or both). Seroconversion of antitoxoplasma immunoglobulin and a discovery of toxoplasma deoxyribonucleic acid in the cerebrospinal fluid (confirmed by use of polymerase chain reaction) were documented in all patients. Treatment consisted of clindamycin therapy (for 2 patients) and of pyrimethamine-clindamycin therapy, sulfadiazine therapy, or both (for 5 patients). Patients showed improvement after therapy, as assessed by clinical and radiological means. Three of 8 patients survive—1 without any residual neurological symptoms and 2 with minimal neurological symptoms. |
| doi_str_mv | 10.1086/317548 |
| format | Article |
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Seroconversion of antitoxoplasma immunoglobulin and a discovery of toxoplasma deoxyribonucleic acid in the cerebrospinal fluid (confirmed by use of polymerase chain reaction) were documented in all patients. Treatment consisted of clindamycin therapy (for 2 patients) and of pyrimethamine-clindamycin therapy, sulfadiazine therapy, or both (for 5 patients). Patients showed improvement after therapy, as assessed by clinical and radiological means. Three of 8 patients survive—1 without any residual neurological symptoms and 2 with minimal neurological symptoms.</description><identifier>ISSN: 1058-4838</identifier><identifier>EISSN: 1537-6591</identifier><identifier>DOI: 10.1086/317548</identifier><identifier>PMID: 11118397</identifier><language>eng</language><publisher>United States: The University of Chicago Press</publisher><subject>Adult ; Animals ; Antibodies, Protozoan - immunology ; Clindamycin - therapeutic use ; Drug Therapy, Combination ; Female ; Hematopoietic Stem Cell Transplantation - adverse effects ; Humans ; Immunoglobulin M - immunology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pyrimethamine - therapeutic use ; Sulfadiazine - therapeutic use ; Tomography, X-Ray Computed ; Toxoplasma ; Toxoplasma - isolation & purification ; Toxoplasmosis, Cerebral - diagnosis ; Toxoplasmosis, Cerebral - drug therapy ; Toxoplasmosis, Cerebral - etiology ; Transplantation, Homologous</subject><ispartof>Clinical infectious diseases, 2001-01, Vol.32 (1), p.e1-e8</ispartof><rights>2001 by the Infectious Diseases Society of America 2001</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-2e61b1054f13a9981b9e818bcff84a57d7a54f2af1bf44005f4575d366602cb3</citedby><cites>FETCH-LOGICAL-c470t-2e61b1054f13a9981b9e818bcff84a57d7a54f2af1bf44005f4575d366602cb3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11118397$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Roemer, E.</creatorcontrib><creatorcontrib>Blau, I. W.</creatorcontrib><creatorcontrib>Basara, N.</creatorcontrib><creatorcontrib>Kiehl, M. G.</creatorcontrib><creatorcontrib>Bischoff, M.</creatorcontrib><creatorcontrib>Günzelmann, S.</creatorcontrib><creatorcontrib>Kirsten, D.</creatorcontrib><creatorcontrib>Sanchez, H.</creatorcontrib><creatorcontrib>Wocker, E. L.</creatorcontrib><creatorcontrib>Fauser, A. A.</creatorcontrib><title>Toxoplasmosis, a Severe Complication in Allogeneic Hematopoietic Stem Cell Transplantation: Successful Treatment Strategies during a 5-Year Single-Center Experience</title><title>Clinical infectious diseases</title><addtitle>Clinical Infectious Diseases</addtitle><addtitle>Clinical Infectious Diseases</addtitle><description>Toxoplasmosis is a rare but often fatal complication that occurs after patients undergo allogeneic hematopoietic stem cell transplant. At our institution, toxoplasmosis was diagnosed in 8 of 301 patients who received stem cell transplants. Disseminated toxoplasmosis with a rapid fatal course was observed in 2 patients. Six patients had cerebral toxoplasmosis diagnosed on the basis of neurological signs and observation of the patients' mental confusion, seizures, and typical lesions (which were assessed by computed tomography, magnetic resonance imaging, or both). Seroconversion of antitoxoplasma immunoglobulin and a discovery of toxoplasma deoxyribonucleic acid in the cerebrospinal fluid (confirmed by use of polymerase chain reaction) were documented in all patients. Treatment consisted of clindamycin therapy (for 2 patients) and of pyrimethamine-clindamycin therapy, sulfadiazine therapy, or both (for 5 patients). Patients showed improvement after therapy, as assessed by clinical and radiological means. Three of 8 patients survive—1 without any residual neurological symptoms and 2 with minimal neurological symptoms.</description><subject>Adult</subject><subject>Animals</subject><subject>Antibodies, Protozoan - immunology</subject><subject>Clindamycin - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>Hematopoietic Stem Cell Transplantation - adverse effects</subject><subject>Humans</subject><subject>Immunoglobulin M - immunology</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pyrimethamine - therapeutic use</subject><subject>Sulfadiazine - therapeutic use</subject><subject>Tomography, X-Ray Computed</subject><subject>Toxoplasma</subject><subject>Toxoplasma - isolation & purification</subject><subject>Toxoplasmosis, Cerebral - diagnosis</subject><subject>Toxoplasmosis, Cerebral - drug therapy</subject><subject>Toxoplasmosis, Cerebral - etiology</subject><subject>Transplantation, Homologous</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkcGOFCEQhonRuOuqj2Dw4slWGJqG9rbp7O6YTGK056B7ITRTTNBuaIE24_v4oLLOxD0ZuUClPr5K5UfoOSVvKJHNW0YFr-UDdE45E1XDW_qwvAmXVS2ZPENPUvpKCKWS8MfojJYjWSvO0a9tOIR51GkKyaXXWOMefkAE3IVpHp3R2QWPnceX4xj24MEZvIZJ5zAHB7lUfYYJdzCOeBu1T8Xl859f73C_GAMp2eWuBzpP4HPho86wd5DwbonO78tMXn0BHXFfqhGqrmAQ8dVhhujAG3iKHlk9Jnh2ui_Q9vpq262rzYeb993lpjK1ILlaQUOHsnNtKdNtK-nQgqRyMNbKWnOxE7r0VtrSwdY1IdzWXPAda5qGrMzALtCro3aO4fsCKavJJVM20x7CkpQo6pY38r8gFVJKshL3oIkhpQhWzdFNOv5UlKi73NQxtwK-OBmXYYLdPXYKqgAvj0BY5n9LqiPjUobDX0rHb6oRTHC1_nyr-k_0erO-_ahu2G9NMa4S</recordid><startdate>20010101</startdate><enddate>20010101</enddate><creator>Roemer, E.</creator><creator>Blau, I. W.</creator><creator>Basara, N.</creator><creator>Kiehl, M. G.</creator><creator>Bischoff, M.</creator><creator>Günzelmann, S.</creator><creator>Kirsten, D.</creator><creator>Sanchez, H.</creator><creator>Wocker, E. L.</creator><creator>Fauser, A. A.</creator><general>The University of Chicago Press</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>M7N</scope><scope>7X8</scope></search><sort><creationdate>20010101</creationdate><title>Toxoplasmosis, a Severe Complication in Allogeneic Hematopoietic Stem Cell Transplantation: Successful Treatment Strategies during a 5-Year Single-Center Experience</title><author>Roemer, E. ; Blau, I. W. ; Basara, N. ; Kiehl, M. G. ; Bischoff, M. ; Günzelmann, S. ; Kirsten, D. ; Sanchez, H. ; Wocker, E. L. ; Fauser, A. 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W.</creatorcontrib><creatorcontrib>Basara, N.</creatorcontrib><creatorcontrib>Kiehl, M. G.</creatorcontrib><creatorcontrib>Bischoff, M.</creatorcontrib><creatorcontrib>Günzelmann, S.</creatorcontrib><creatorcontrib>Kirsten, D.</creatorcontrib><creatorcontrib>Sanchez, H.</creatorcontrib><creatorcontrib>Wocker, E. L.</creatorcontrib><creatorcontrib>Fauser, A. A.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Roemer, E.</au><au>Blau, I. W.</au><au>Basara, N.</au><au>Kiehl, M. G.</au><au>Bischoff, M.</au><au>Günzelmann, S.</au><au>Kirsten, D.</au><au>Sanchez, H.</au><au>Wocker, E. L.</au><au>Fauser, A. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Toxoplasmosis, a Severe Complication in Allogeneic Hematopoietic Stem Cell Transplantation: Successful Treatment Strategies during a 5-Year Single-Center Experience</atitle><jtitle>Clinical infectious diseases</jtitle><stitle>Clinical Infectious Diseases</stitle><addtitle>Clinical Infectious Diseases</addtitle><date>2001-01-01</date><risdate>2001</risdate><volume>32</volume><issue>1</issue><spage>e1</spage><epage>e8</epage><pages>e1-e8</pages><issn>1058-4838</issn><eissn>1537-6591</eissn><abstract>Toxoplasmosis is a rare but often fatal complication that occurs after patients undergo allogeneic hematopoietic stem cell transplant. At our institution, toxoplasmosis was diagnosed in 8 of 301 patients who received stem cell transplants. Disseminated toxoplasmosis with a rapid fatal course was observed in 2 patients. Six patients had cerebral toxoplasmosis diagnosed on the basis of neurological signs and observation of the patients' mental confusion, seizures, and typical lesions (which were assessed by computed tomography, magnetic resonance imaging, or both). Seroconversion of antitoxoplasma immunoglobulin and a discovery of toxoplasma deoxyribonucleic acid in the cerebrospinal fluid (confirmed by use of polymerase chain reaction) were documented in all patients. Treatment consisted of clindamycin therapy (for 2 patients) and of pyrimethamine-clindamycin therapy, sulfadiazine therapy, or both (for 5 patients). Patients showed improvement after therapy, as assessed by clinical and radiological means. 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| subjects | Adult Animals Antibodies, Protozoan - immunology Clindamycin - therapeutic use Drug Therapy, Combination Female Hematopoietic Stem Cell Transplantation - adverse effects Humans Immunoglobulin M - immunology Magnetic Resonance Imaging Male Middle Aged Pyrimethamine - therapeutic use Sulfadiazine - therapeutic use Tomography, X-Ray Computed Toxoplasma Toxoplasma - isolation & purification Toxoplasmosis, Cerebral - diagnosis Toxoplasmosis, Cerebral - drug therapy Toxoplasmosis, Cerebral - etiology Transplantation, Homologous |
| title | Toxoplasmosis, a Severe Complication in Allogeneic Hematopoietic Stem Cell Transplantation: Successful Treatment Strategies during a 5-Year Single-Center Experience |
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