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Diagnosis of pulmonary toxoplasmosis by bronchoalveolar lavage in cardiac transplant recipients
Author(s) -
Gordon Steven M.,
Gal Anthony A.,
Hertzler Gary L.,
Bryan John A.,
Perlino Carl,
Kanter Kirk R.
Publication year - 1993
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.2840090609
Subject(s) - bronchoalveolar lavage , medicine , toxoplasmosis , toxoplasma gondii , serology , pathology , pneumonia , transplantation , pneumocystis carinii , differential diagnosis , h&e stain , antibody , immunology , lung , immunohistochemistry , surgery , pneumocystis jirovecii
We report two cases of fatal, clinically unsuspected disseminated toxoplasmosis that developed following orthotopic cardiac transplantation. Toxoplasma gondii trophozoites, pseudocysts, and cysts were best visualized on hematoxylin and eosin and Giemsastained cytospin preparations of bronchoalveolar lavage fluid. Post‐mortem examination in both cases revealed disseminated toxoplasmosis with extensive involvement of the lungs and heart. The patients, who were seronegative for antibody to T. gondii prior to transplantation, received organs from donors whose serology status was unknown. Demonstration of anti‐toxoplasma antibodies post‐transplantation occurred in both cases. Bronchoalveolar lavage may be useful in diagnosis of pulmonary toxoplasmosis. Clinicians, pathologists, and cytopathologists must consider T. gondii in the differential diagnosis of pneumonia in the immunocompromised patient, especially cardiac transplant patients.