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Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure

Although primary toxoplasmosis is a rare event following kidney transplantation, it can be life threatening. This report describes this complication. The patient presented with high-grade fever, haemolytic anaemia and haemophagocytic-syndrome-related pancytopaenia. Toxoplasma gondii diagnosis was as...

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Autores principales: Hébraud, Benjamin, Kamar, Nassim, Borde, Jean-Sébastien, Bessières, Marie-Hélène, Galinier, Michel, Rostaing, Lionel
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584227/
https://www.ncbi.nlm.nih.gov/pubmed/19020669
http://dx.doi.org/10.1093/ndtplus/sfn159
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author Hébraud, Benjamin
Kamar, Nassim
Borde, Jean-Sébastien
Bessières, Marie-Hélène
Galinier, Michel
Rostaing, Lionel
author_facet Hébraud, Benjamin
Kamar, Nassim
Borde, Jean-Sébastien
Bessières, Marie-Hélène
Galinier, Michel
Rostaing, Lionel
author_sort Hébraud, Benjamin
collection PubMed
description Although primary toxoplasmosis is a rare event following kidney transplantation, it can be life threatening. This report describes this complication. The patient presented with high-grade fever, haemolytic anaemia and haemophagocytic-syndrome-related pancytopaenia. Toxoplasma gondii diagnosis was ascertained by blood and bone-marrow PCR assays. After 6 weeks with Clindamycin plus pyrimethamine therapies and despite negativation of T. gondii blood PCR assay, the patient developed left-ventricular failure. After adding sulfamethoxazole/ trimethoprim, ramipril, digoxine, bisoprolol and spironolactone, he progressively recovered. Anti-T. gondii therapy was continued for 6 months. Four years later he received a third kidney allograft: at that time anti-T. gondii antibodies had become negative. The outcome was uneventful despite immunosuppression but with inclusion of sulfamethoxazole/trimethoprim prophylaxis. More than 3 years after the third kidney transplantation the patient has had no toxoplasmosis reactivation. This case report highlights that T. gondii can be the cause of myocarditis in a renal transplant recipient.
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spelling pubmed-25842272009-02-25 Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure Hébraud, Benjamin Kamar, Nassim Borde, Jean-Sébastien Bessières, Marie-Hélène Galinier, Michel Rostaing, Lionel NDT Plus Case Reports Although primary toxoplasmosis is a rare event following kidney transplantation, it can be life threatening. This report describes this complication. The patient presented with high-grade fever, haemolytic anaemia and haemophagocytic-syndrome-related pancytopaenia. Toxoplasma gondii diagnosis was ascertained by blood and bone-marrow PCR assays. After 6 weeks with Clindamycin plus pyrimethamine therapies and despite negativation of T. gondii blood PCR assay, the patient developed left-ventricular failure. After adding sulfamethoxazole/ trimethoprim, ramipril, digoxine, bisoprolol and spironolactone, he progressively recovered. Anti-T. gondii therapy was continued for 6 months. Four years later he received a third kidney allograft: at that time anti-T. gondii antibodies had become negative. The outcome was uneventful despite immunosuppression but with inclusion of sulfamethoxazole/trimethoprim prophylaxis. More than 3 years after the third kidney transplantation the patient has had no toxoplasmosis reactivation. This case report highlights that T. gondii can be the cause of myocarditis in a renal transplant recipient. Oxford University Press 2008-12 2008-10-18 /pmc/articles/PMC2584227/ /pubmed/19020669 http://dx.doi.org/10.1093/ndtplus/sfn159 Text en © The Author [2008]. http://creativecommons.org/licenses/by-nc/2.0/uk/ The online version of this article has been published under an open access model http://creativecommons.org/licenses/by-nc/2.0/uk/. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org
spellingShingle Case Reports
Hébraud, Benjamin
Kamar, Nassim
Borde, Jean-Sébastien
Bessières, Marie-Hélène
Galinier, Michel
Rostaing, Lionel
Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
title Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
title_full Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
title_fullStr Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
title_full_unstemmed Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
title_short Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
title_sort unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584227/
https://www.ncbi.nlm.nih.gov/pubmed/19020669
http://dx.doi.org/10.1093/ndtplus/sfn159
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