title: Hemophagocytic syndrome as uncommon presentation of disseminated toxoplasmosis in an immunocompetent adult from Chinese Kunming.
abstract: Hemophagocytic syndrome is a rare disease that is often fatal, despite treatment. An immunocompetent patient was presented with fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia, which conformed to a hemophagocytic syndrome diagnosis. Despite broad antibiotic treatment, the patient's clinical condition rapidly deteriorated and he died within 8 days of admission. Blood cultures and a serology test were negative; however, based on morphological characteristics, tissue cysts Toxoplasma gondii were found in the bone marrow. Based on polymerase chain reaction analysis, identity of the parasite was confirmed. Although very rare, T. gondii-associated hemophagocytic syndrome should be suspected in the case of cytopenia or multiorgan failure symptoms. To our knowledge, this is the first fatal toxoplasmosis case reported from China.
authors.affiliation: Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China. 12011000936@mail.ynu.edu.cn
authors.forename: YanFen
authors.initials: Y
authors.lastname: Yang
authors.forename: WeiWei
authors.initials: W
authors.lastname: Zuo
authors.forename: JunJie
authors.initials: J
authors.lastname: Hu
authors.forename: Gerald W
authors.initials: GW
authors.lastname: Esch
authors.forename: YangXian
authors.initials: Y
authors.lastname: Zuo
mesh_terms: D000328:Adult; D000617:Aminoglycosides / Q000627:therapeutic use; D044466:Asian People; D001853:Bone Marrow; D002438:Cefoperazone / Q000627:therapeutic use; D002681:China; D016054:DNA, Protozoan / Q000302:isolation & purification*; D017809:Fatal Outcome; D006801:Humans; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis* / Q000209:etiology / Q000469:parasitology; D008297:Male; D010397:Penicillanic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D016036:Seroepidemiologic Studies; D000078142:Tazobactam; D014122:Toxoplasma / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000150:complications / Q000175:diagnosis*
chemical_list: D000617:Aminoglycosides; D016054:DNA, Protozoan; D002438:Cefoperazone; D010397:Penicillanic Acid; C448680:etimicin; D000078142:Tazobactam