Kollu Vidya, Magalhaes-Silverman Margarida, Tricot Guido, Ince Dilek
University of Iowa, Department of Internal Medicine, Divisions of Hematology, Oncology, and Blood and Bone Marrow Transplant, Iowa City, IA, USA.
University of Iowa, Department of Internal Medicine, Division of Infectious Diseases, Iowa City, IA, USA.
Case Rep Infect Dis. 2018 Nov 11;2018:9409121. doi: 10.1155/2018/9409121. eCollection 2018.
Infection with is a rare but often fatal complication in hematopoietic stem cell transplantation (HSCT) recipients. Most cases have been reported in allogeneic (allo-) HSCT recipients, with only narrative reports following autologous HSCT (ASCT). We report the case of a 58-year-old Caucasian male presenting with toxoplasma encephalitis following tandem ASCT for myeloma and successfully treated with diagnosis by polymerase chain reaction analysis of cerebrospinal fluid. He was treated with sulfadiazine and pyrimethamine (with leucovorin) followed by pyrimethamine and atovaquone as secondary prophylaxis while receiving subsequent therapy for progressive multiple myeloma. Toxoplasmosis is a potential complication in allo-HSCT as well as ASCT recipients and should be considered in any post-HSCT patient with neurological dysfunction. Rapid diagnosis and immediate antimicrobial treatment are essential to avoid morbidity and mortality.
感染在造血干细胞移植（HSCT）受者中是一种罕见但往往致命的并发症。大多数病例报告于异基因（allo-）HSCT受者，自体HSCT（ASCT）后仅有病例报道。我们报告了一例58岁的白种男性，在接受串联ASCT治疗骨髓瘤后出现弓形虫脑炎，并通过脑脊液聚合酶链反应分析成功确诊并接受治疗。他先接受了磺胺嘧啶和乙胺嘧啶（加亚叶酸）治疗，随后接受乙胺嘧啶和阿托伐醌作为二级预防，同时接受后续进展性多发性骨髓瘤治疗。弓形虫病在allo-HSCT以及ASCT受者中都是一种潜在并发症，任何出现神经功能障碍的HSCT后患者都应考虑该病。快速诊断和立即进行抗菌治疗对于避免发病和死亡至关重要。
