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Cutaneous toxoplasmosis: a case of confounding diagnosis

Bone Marrow Transplantation volume 36, pages 465–466 (2005)Cite this article

Toxoplasma gondii can lead to serious life-threatening infections in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT).1, 2 The overall prevalence of toxoplasmosis in stem cell transplant recipients range from <0.5% in the United States up to 3–5% in Europe where infection rates are higher in the general population.3, 4, 5 T. gondii reactivation mainly involves the central nervous system. Pneumonia may occur occasionally, however, skin involvement is rare even in severely immunosuppressed individuals.6, 7 We present a patient who developed multiple skin lesions during the early post transplant period.

On day 13, his fever had resolved, although progressive respiratory failure requiring assisted ventilation, presence of azotemia, and severe hepatic dysfunction heralded poor prognosis. At 15 days after receiving marrow transplant, despite signs of early engraftment (absolute neutrophil count 880 cells/Ul), the patient succumbed to multisystem organ failure. A postmortem examination demonstrated autolytic and congestive changes in liver, spleen and gastrointestinal tract, acute renal tubular necrosis, bone marrow showed no evidence of leukemia. Skin findings were consistent with acute graft-versus-host disease; T. gondii was not seen.

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  1. The University of Texas MD, Anderson Cancer Center, Houston, TX, USA

    S A Lee, A H Diwan, M Cohn, R Champlin & A Safdar

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  1. S A Lee
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  2. A H Diwan
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  3. M Cohn
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  4. R Champlin
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  5. A Safdar
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Lee, S., Diwan, A., Cohn, M. et al. Cutaneous toxoplasmosis: a case of confounding diagnosis. Bone Marrow Transplant 36, 465–466 (2005). https://doi.org/10.1038/sj.bmt.1705079

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