Acute disseminated fatal toxoplasmosis after haploidentical stem cell transplantation despite atovaquone prophylaxis in a young man.
We describe a case of fatal acute disseminated breakthrough toxoplasmosis in a 19-year-old adolescent after haploidentical hematopoietic stem cell transplantation for acute lymphoblastic leukemia despite continued atovaquone prophylaxis. Diagnosis was at necropsy, and confirmed by postmortem polymerase chain reaction analysis in plasma. This report illustrates the need for protozoal monitoring despite atovaquone prophylaxis, in severely immunocompromised patients with intolerance to standard treatment.
Garcia de la Fuente
Isabel
I
Department of Pediatrics, Division of General Pediatrics, University Hospitals of Geneva, Geneva, Switzerland.
Ansari
Marc
M
Rougemont
Anne-Laure
AL
Passweg
Jakob R
JR
Gumy-Pause
Fabienne
F
Ozsahin
Hulya
H
Lobrinus
Johannes A
JA
Posfay-Barbe
Klara M
KM
D000208:Acute Disease; D000890:Anti-Infective Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D053626:Atovaquone / Q000627:therapeutic use*; D017809:Fatal Outcome; D006238:Haploidy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000601:surgery; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014123:Toxoplasmosis / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control; D017211:Treatment Failure; D055815:Young Adult
D000890:Anti-Infective Agents; D053626:Atovaquone