Mayes J T, O'Connor B J, Avery R, Castellani W, Carey W
Division of Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
Clin Infect Dis. 1995 Sep;21(3):511-5. doi: 10.1093/clinids/21.3.511.
Toxoplasmosis is an important disease in immunocompromised hosts, particularly in patients with AIDS and in heart transplant recipients. Infection with Toxoplasma is less commonly seen in recipients of other solid organ transplants. We report a case of fulminant disseminated infection with Toxoplasma after liver transplantation. Despite numerous diagnostic studies including open lung biopsy, toxoplasmosis was diagnosed only at the time of autopsy and involved the brain, spinal cord, pituitary gland, lungs, and heart. Toxoplasmosis should be considered in the differential diagnosis of multiorgan failure in the early period after liver transplantation. If mismatched serologies could be identified then clinical suspicion might be higher and prophylactic or empirical therapy could be instituted. The United Network for Organ Sharing (Richmond, VA) should consider including serology for Toxoplasma in the testing of donors.
弓形虫病在免疫功能低下的宿主中是一种重要疾病，尤其是在艾滋病患者和心脏移植受者中。在其他实体器官移植受者中，弓形虫感染较少见。我们报告一例肝移植后发生的暴发性播散性弓形虫感染病例。尽管进行了包括开胸肺活检在内的大量诊断性检查，但弓形虫病仅在尸检时才被诊断出来，且累及脑、脊髓、垂体、肺和心脏。在肝移植后的早期，多器官功能衰竭的鉴别诊断中应考虑弓形虫病。如果能够识别出不匹配的血清学结果，那么临床怀疑可能会更高，从而可以开始预防性或经验性治疗。器官共享联合网络（弗吉尼亚州里士满）应考虑在供体检测中纳入弓形虫血清学检查。
