title: Trichomonas foetus meningoencephalitis after allogeneic peripheral blood stem cell transplantation.
abstract: A 34-year-old man with refractory acute myelogenous leukemia underwent allogeneic peripheral blood stem cell transplantation (PBSCT) from his HLA-matched sibling. Engraftment was prompt and no acute GVHD developed. However, high fever persisted even after engraftment, and the patient developed headache, diplopia, vertigo and nuchal rigidity on day 20 posttransplant. Cerebrospinal fluid (CSF) showed pleocytosis with no detectable microorganisms. Despite therapy with broad-spectrum antibiotics, antifungal agents and antituberculous drugs, he developed rapid mental deterioration with seizures and died on day 40. Just prior to his death, trichomonads were isolated from both CSF and urine. Scanning electron microscopic examination identified the trichomonad as Trichomonas foetus. At autopsy, trichomonads were detected histopathologically in an area involving meningoencephalitis. To our knowledge, this is the first case of T. foetus meningoencephalitis in a recipient of allogeneic PBSCT and, more importantly, the first human case of T. foetus infection.
authors.affiliation: Keio Bone Marrow Transplant Program, Department of Medicine, Keio University, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Okamoto
authors.forename: M
authors.initials: M
authors.lastname: Wakui
authors.forename: H
authors.initials: H
authors.lastname: Kobayashi
authors.forename: N
authors.initials: N
authors.lastname: Sato
authors.forename: A
authors.initials: A
authors.lastname: Ishida
authors.forename: M
authors.initials: M
authors.lastname: Tanabe
authors.forename: T
authors.initials: T
authors.lastname: Takeuchi
authors.forename: S
authors.initials: S
authors.lastname: Fukushima
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: Y
authors.initials: Y
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008590:Meningoencephalitis / Q000209:etiology*; D014184:Transplantation, Homologous; D014245:Trichomonas Infections / Q000209:etiology*