title: Post-prophylaxis Toxoplasma chorioretinitis following donor-recipient mismatched liver transplantation.
abstract: Toxoplasmosis may be transferred by organ transplantation. The most common clinical presentation is with multisystem disease, although isolated ocular toxoplasmosis has been described. Many centers have suggested that universal use of co-trimoxazole prophylaxis obviates the need for specific Toxoplasma testing. We report a case of donor-acquired ocular toxoplasmosis after liver transplantation despite co-trimoxazole prophylaxis. The diagnosis was confirmed by Toxoplasma polymerase chain reaction assay in conjunction with seroconversion. The fact that the infection was donor acquired was confirmed by serological mismatch and the absence of sporozoite-specific antigen antibody in the recipient.
authors: National Institute of Health Research Birmingham Liver Biomedical Research Unit, Birmingham, UK.
authors: G J
authors: http://orcid.org/0000-0002-0710-5644
authors: GJ
authors: Webb
authors: National Institute of Health Research Birmingham Liver Biomedical Research Unit, Birmingham, UK.
authors: H
authors: H
authors: Shah
authors: Clinical Microbiology, Queen Elizabeth Hospital, Birmingham, UK.
authors: M D
authors: http://orcid.org/0000-0002-6756-0550
authors: MD
authors: David
authors: St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors: S
authors: S
authors: Tiew
authors: St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
authors: N
authors: N
authors: Beare
authors: National Institute of Health Research Birmingham Liver Biomedical Research Unit, Birmingham, UK. g.hirschfield@bham.ac.uk.
authors: G M
authors: GM
authors: Hirschfield
mesh_terms: D000328:Adult; D064591:Allografts / Q000469:parasitology*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects* / Q000379:methods*; D000953:Antigens, Protozoan / Q000276:immunology; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D002825:Chorioretinitis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000379:methods; D017114:Liver Failure, Acute / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects*; D016133:Polymerase Chain Reaction; D000069078:Seroconversion; D012698:Serologic Tests; D014122:Toxoplasma / Q000276:immunology / Q000302:isolation & purification*; D014126:Toxoplasmosis, Ocular / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D014184:Transplantation, Homologous / Q000009:adverse effects; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000953:Antigens, Protozoan; D000981:Antiprotozoal Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: 
  Toxoplasma gondii
  ; chorioretinitis; disease transmission; immunosuppression; infectious; liver transplantation; ocular; toxoplasmosis