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Cerebral toxoplasmosis in an adolescent post allogeneic hematopoietic stem cell transplantation: successful outcome by antiprotozoal chemotherapy and CD 4 + T‐lymphocyte recovery
Author(s) -
Kerl K.,
Ehlert K.,
Brentrup A.,
Schiborr M.,
Keyvani K.,
Becker K.,
Rossig C.,
Groll A.H.
Publication year - 2015
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12344
Subject(s) - medicine , toxoplasmosis , hematopoietic stem cell transplantation , stem cell , lymphoma , chemotherapy , donor lymphocyte infusion , immunology , hematopoietic stem cell , transplantation , haematopoiesis , oncology , biology , genetics
Toxoplasmosis is a rare opportunistic infection in pediatric allogeneic hematopoietic stem cell transplant (allo‐ HSCT ) recipients and associated with severe T‐cell deficiency. Here, we report the successful management of cerebral toxoplasmosis in a 15‐year‐old adolescent 4 months post allo‐ HSCT for non‐Hodgkin lymphoma through rapid invasive diagnostics, long‐term antiprotozoal chemotherapy, and an hematopoietic stem cell boost for persistently poor graft function. While supportive care and antiprotozoal chemotherapy achieved stabilization, definite improvement only occurred following recovery of CD 4 + T lymphocytes to >100 cells/μL. At 5 years after the diagnosis of toxoplasmosis, the patient is in continuing remission with normalized clinical and imaging findings.