title: Acute disseminated fatal toxoplasmosis after haploidentical stem cell transplantation despite atovaquone prophylaxis in a young man.
abstract: 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.
authors: Department of Pediatrics, Division of General Pediatrics, University Hospitals of Geneva, Geneva, Switzerland.
authors: Isabel
authors: I
authors: Garcia de la Fuente
authors: Marc
authors: M
authors: Ansari
authors: Anne-Laure
authors: AL
authors: Rougemont
authors: Jakob R
authors: JR
authors: Passweg
authors: Fabienne
authors: F
authors: Gumy-Pause
authors: Hulya
authors: H
authors: Ozsahin
authors: Johannes A
authors: JA
authors: Lobrinus
authors: Klara M
authors: KM
authors: Posfay-Barbe
mesh_terms: 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
chemical_list: D000890:Anti-Infective Agents; D053626:Atovaquone