Medical School, University of Minnesota, Minneapolis, MN, USA.
Department of Pediatrics, Division of Blood and Marrow Transplantation and Cellular Therapy, University of Minnesota, Minneapolis, MN, USA.
BMC Infect Dis. 2021 Sep 10;21(1):941. doi: 10.1186/s12879-021-06650-2.
Cerebral toxoplasmosis infection presents with non-specific neurologic symptoms in immunocompromised patients. With lack of measurable adaptive immune responses and reluctance to sample affected brain tissue, expedient diagnosis to guide directed treatment is often delayed.
We describe the use of cerebrospinal fluid polymerase chain reaction and plasma cell-free DNA technologies to supplement neuroimaging in the diagnosis of cerebral toxoplasmosis in an immunocompromised pediatric patient following allogeneic hematopoietic cell transplantation for idiopathic severe aplastic anemia. Successful cerebral toxoplasmosis treatment included antibiotic therapy for 1 year following restoration of cellular immunity with an allogeneic stem cell boost.
Plasma cell-free DNA technology provides a non-invasive method of rapid diagnosis, improving the likelihood of survival from often lethal opportunistic infection in a high risk, immunocompromised patient population.
脑弓形体病感染在免疫功能低下的患者中表现为非特异性神经症状。由于缺乏可测量的适应性免疫反应，并且不愿采集受影响的脑组织样本，因此通常会延迟进行有助于指导治疗的快速诊断。
我们描述了在异基因造血细胞移植治疗特发性严重再生障碍性贫血后，使用脑脊液聚合酶链反应和血浆无细胞 DNA 技术来补充神经影像学检查，以辅助诊断免疫功能低下的儿科患者的脑弓形体病。成功的脑弓形体病治疗包括在异体干细胞增强恢复细胞免疫后进行为期 1 年的抗生素治疗。
血浆无细胞 DNA 技术为快速诊断提供了一种非侵入性方法，提高了高危免疫功能低下患者人群中经常致命的机会性感染的生存机会。
