Bretagne S, Costa J M, Kuentz M, Simon D, Vidaud M, Fortel I, Vernant J P, Cordonnier C
Laboratoire de Parasitologie, Hôpital Henri Mondor, Créteil, France.
Bone Marrow Transplant. 1995 May;15(5):809-11.
We report a case of disseminated toxoplasmosis occurring 12 months after allogeneic BMT. The patient was seropositive for Toxoplasma gondii, and the donor was seronegative, so the patient was given anti-Toxoplasma prophylaxis. One year after BMT, he developed fever and muscle pain without other clinical symptoms. PCR amplification for T. gondii performed on blood was positive. Toxoplasma were found in bronchoalveolar lavage by PCR and in the marrow by special stains. With treatment, the PCR signal disappeared in 3 days while clinical symptoms resolved over 15 days. This case emphasizes the possibility of late toxoplasmosis after BMT despite prophylatic treatment, and the value of PCR in making the diagnosis.
我们报告1例异基因骨髓移植（BMT）12个月后发生播散性弓形虫病的病例。该患者弓形虫血清学检测呈阳性，而供者为血清学阴性，因此患者接受了抗弓形虫预防治疗。BMT后1年，他出现发热和肌肉疼痛，无其他临床症状。血液中进行的弓形虫PCR扩增呈阳性。通过PCR在支气管肺泡灌洗物中以及通过特殊染色在骨髓中发现了弓形虫。经过治疗，PCR信号在3天内消失，而临床症状在15天内得到缓解。该病例强调了尽管进行了预防性治疗，但BMT后仍可能发生迟发性弓形虫病，以及PCR在诊断中的价值。
