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- Title
Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure.
- Authors
Hébraud, Benjamin; Kamar, Nassim; Borde, Jean-Sébastien; Bessières, Marie-Hélène; Galinier, Michel; Rostaing, Lionel
- Abstract
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.
- Subjects
KIDNEY diseases; CHRONIC kidney failure; KIDNEY transplantation; HEART failure; TOXOPLASMOSIS; MYOCARDITIS
- Publication
NDT Plus, 2008, Vol 1, Issue 6, p429
- ISSN
1753-0784
- Publication type
Article
- DOI
10.1093/ndtplus/sfn159