ABSTRACT
We report the case of a 61 year-old male who underwent heart transplantation eight months before developing a systemic condition with central nervous system, lung, kidney, colonic, cutaneous, and hematologic involvement, found to be secondary to a systemic toxoplasmosis despite co-trimoxazole prophylaxis in a previous-to-transplant seronegative patient receiving a heart from a seropositive donor. A review of prophylactic options in our environment is discussed.
Subject(s)
Heart Transplantation , Postoperative Complications/etiology , Toxoplasmosis/transmission , Antibodies, Protozoan/blood , Antiviral Agents/therapeutic use , Combined Modality Therapy , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/transmission , Disease Progression , Humans , Immunoglobulins, Intravenous/therapeutic use , Immunosuppressive Agents/adverse effects , Male , Middle Aged , Plasma Exchange , Postoperative Complications/parasitology , Postoperative Complications/prevention & control , Recurrence , Seroconversion , Tissue Donors , Toxoplasmosis/prevention & control , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosage , Viremia/drug therapy , Viremia/transmissionABSTRACT
Resumen Se reporta el caso de un paciente de sexo masculino, de 61 años de edad, quien ocho meses después de someterse a un trasplante de corazón presentó una enfermedad sistémica con compromiso del sistema nervioso central y del sistema inmunológico, así como de pulmón, riñón, colon y piel, y a quien finalmente se le diagnosticó toxoplasmosis diseminada, a pesar de haber recibido profilaxis con trimetoprim-sulfametoxazol, debido a que el órgano provenía de un donante positivo para toxoplasmosis siendo él un receptor negativo. Se discuten las opciones de profilaxis en nuestro medio.
Abstract We report the case of a 61 year-old male who underwent heart transplantation eight months before developing a systemic condition with central nervous system, lung, kidney, colonic, cutaneous, and hematologic involvement, found to be secondary to a systemic toxoplasmosis despite co-trimoxazole prophylaxis in a previous-to-transplant seronegative patient receiving a heart from a seropositive donor. A review of prophylactic options in our environment is discussed.