| Abstract | Toxoplasmosis is a rare but life-threatening complication of allogeneic stem-cell transplantation. Polymerase chain reaction (PCR) offers the possibility to make the diagnosis earlier than conventional techniques, and is then expected to improve the prognosis. We undertook a prospective screening using a competitive PCR in blood in 32 stem-cell transplant recipients. The sampling covered the first 150 days post-transplant, at days 21, 30, 45, 60, 90, 120, and 150. Twenty-four patients had anti-toxoplasma antibodies before transplant. Three of them (12.5%) had transient PCR-positive samples at 21, 45, and 90 days post-transplant, respectively. The three PCR-positive patients were febrile but had no funduscopic examination or cerebral computerised tomography (CT) scan abnormalities. The PCR signal disappeared when the patients were given trimethoprim-sulfamethoxazole, and no full-blown toxoplasmosis was observed. Toxoplasma reactivation evidenced using PCR is frequent in seropositive patients not receiving trimethoprim-sulfamethoxazole during the 1-3 months post-transplant. Toxoplasma PCR should be included in the diagnostic strategy of fever of unexplained origin in allogeneic stem-cell transplant recipients. Then, prompt specific therapy can be initiated to avoid development of full-blown toxoplasmosis. |
| Authors | S Bretagne, J M Costa, F Foulet, L Jabot-Lestang, F Baud-Camus, C Cordonnier
(Affiliation: Laboratoire de Parasitologie-Mycologie, Hôpital Henri Mondor, Créteil, France. bretagne at univ-paris12.fr)
|
| Journal | Transplant infectious disease : an official journal of the Transplantation Society
(Transpl Infect Dis)
Vol. 2
Issue 3
Pg. 127-32
(Sep 2000)
ISSN: 1398-2273 Sweden |
| PMID | 11429023
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
|
| Chemical References |
- Anti-Infective Agents
- Antibodies, Protozoan
- Trimethoprim-Sulfamethoxazole Combination
|
| Topics |
- Adult
- Anemia, Aplastic
(therapy)
- Animals
- Anti-Infective Agents
(therapeutic use)
- Antibodies, Protozoan
(blood)
- Child
- Female
- Hematopoietic Stem Cell Transplantation
(adverse effects)
- Humans
- Leukemia
(therapy)
- Male
- Middle Aged
- Polymerase Chain Reaction
(methods)
- Prospective Studies
- Toxoplasma
(growth & development, isolation & purification)
- Toxoplasmosis
(diagnosis, prevention & control)
- Transplantation, Homologous
- Trimethoprim-Sulfamethoxazole Combination
(therapeutic use)
|
