title: Cytomegalovirus infections and toxoplasmosis in heart transplant recipients in Sweden.
abstract: The morbidity of cytomegalovirus (CMV) infection and toxoplasmosis was evaluated in 75 heart transplant recipients. Among the 73 patients who survived more than one week after transplantation, 16 (22%) acquired primary CMV infection and 30 (41%) had evidence of secondary infection. All CMV seronegative recipients receiving hearts from seropositive donors developed CMV infection. The majority of infections (42/46) occurred during the first 4 months after transplantation. Overall, the incidence of symptomatic CMV disease was 44%. The infections were generally mild and only 1 death was attributed to primary CMV disease complicated by bacterial septicaemia and multiple organ failure. The severity of CMV disease was greatest among those with primary infection. There were 3 cases of toxoplasmosis. Two patients were toxoplasma seronegative before transplantation and developed clinical and serological signs of infection 2-3 months after transplantation despite receiving organs from seronegative donors. Of toxoplasma seronegative recipients receiving allografts from seropositive donors 3/4 were prophylactically treated with pyrimethamine for 6 weeks. None developed clinical or serological signs of toxoplasmosis while one patient who received trimethoprim-sulfamethoxazole had a subclinical infection.
authors.affiliation: Department of Infectious Diseases, Ostra Hospital, Göteborg, Sweden.
authors.forename: R
authors.initials: R
authors.lastname: Andersson
authors.forename: T
authors.initials: T
authors.lastname: Sandberg
authors.forename: E
authors.initials: E
authors.lastname: Berglin
authors.forename: S
authors.initials: S
authors.lastname: Jeansson
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D013548:Sweden / Q000453:epidemiology; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality
chemical_list: D000913:Antibodies, Protozoan; D000914:Antibodies, Viral