Miyagi T, Itonaga H, Aosai F, Taguchi J, Norose K, Mochizuki K, Fujii H, Furumoto A, Ohama M, Karimata K, Yamanoha A, Taniguchi H, Sato S, Taira N, Moriuchi Y, Fukushima T, Masuzaki H, Miyazaki Y
Department of Hematology, Heartlife Hospital, Okinawa, Japan.
Department of Hematology, Sasebo City General Hospital, Sasebo, Japan.
Transpl Infect Dis. 2015 Aug;17(4):593-8. doi: 10.1111/tid.12401. Epub 2015 Jun 26.
Toxoplasmic encephalitis represents a rare, but often fatal infection after allogeneic hematopoietic stem cell transplantation. Polymerase chain reaction (PCR)-based preemptive therapy is considered promising for this disease, but is not routinely applied, especially in low seroprevalence countries including Japan. We encountered 2 cases of toxoplasmic encephalitis after transplantation that were successfully treated. The diagnosis of toxoplasmic encephalitis in these cases was confirmed by PCR testing when neurological symptoms were observed. Both patients received pyrimethamine and sulfadiazine treatments within 2 weeks of the development of neurological symptoms, and remained free of recurrence for 32 and 12 months. These results emphasized the importance of the PCR test and immediate treatment after diagnosis for the management of toxoplasmic encephalitis.
弓形虫性脑炎是异基因造血干细胞移植后一种罕见但往往致命的感染。基于聚合酶链反应（PCR）的抢先治疗被认为对这种疾病有前景，但尚未常规应用，尤其是在包括日本在内的血清阳性率较低的国家。我们遇到了2例移植后发生的弓形虫性脑炎并成功治疗。当观察到神经症状时，通过PCR检测确诊了这些病例中的弓形虫性脑炎。两名患者在出现神经症状后的2周内均接受了乙胺嘧啶和磺胺嘧啶治疗，并且分别在32个月和12个月内未复发。这些结果强调了PCR检测以及诊断后立即治疗对于弓形虫性脑炎管理的重要性。
