Cutaneous toxoplasmosis after bone marrow transplantation with molecular confirmation

Journal of the American Academy of Dermatology
Gail AmirRebekah Karplus

Abstract

Toxoplasmosis is a rare and often fatal complication of hematopoietic stem cell transplantation (HSCT). The diagnosis of toxoplasmosis is usually made at autopsy because of the variety of systemic manifestations and the difficulty of diagnosis by serologic methods in the severely immunocompromised patient. Cutaneous toxoplasmosis in this setting is extremely rare and is difficult to diagnose with certainty because of the morphologic similarity of Toxoplasma gondii to other organisms, such as Leishmania and Histoplasma species. We report a patient who developed systemic toxoplasmosis, manifested as encephalitis and cutaneous lesions, after HSCT. Findings of a skin biopsy led to a tentative histologic diagnosis of toxoplasmosis, confirmed by polymerase chain reaction (PCR) examination of the skin biopsy and cerebrospinal fluid. This is, to our knowledge, the first report of cutaneous toxoplasmosis diagnosed by skin biopsy confirmed by PCR and sequencing. This disease may be more common than is generally appreciated in severely immunocompromised patients. PCR is a valuable adjunct to diagnosis.

References

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Citations

Feb 8, 2013·Journal of Clinical Microbiology·Stefan ZimmermannPaul Schnitzler
Jul 3, 2016·Journal of the Formosan Medical Association = Taiwan Yi Zhi·Wei-Li YangJulia Yu-Yun Lee
Apr 25, 2012·Journal of Veterinary Diagnostic Investigation : Official Publication of the American Association of Veterinary Laboratory Diagnosticians, Inc·Aline Rodrigues HoffmannJoanne Mansell
Oct 3, 2017·Biomédica : revista del Instituto Nacional de Salud·Victoria DávilaJavier Mauricio González
Mar 13, 2014·The American Journal of Dermatopathology·Andrew J RandM Angelica Selim
Jun 2, 2018·Expert Review of Anti-infective Therapy·Céline DardChristelle Pomares
Apr 13, 2021·Transplantation and Cellular Therapy·Hayden T SchwenkDespina G Contopoulos-Ioannidis

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