TY - JOUR T1 - Toxoplasmosis in cord blood transplantation recipients. JF - Transplant infectious disease : an official journal of the Transplantation Society// Transpl Infect Dis Y1 - 2012 A1 - Bautista, G A1 - Ramos, A A1 - Fores, R A1 - Regidor, C A1 - Ruiz, E A1 - de Laiglesia, A A1 - Navarro, B A1 - Bravo, J A1 - Portero, F A1 - Sanjuan, I A1 - Fernandez, M N A1 - Cabrera, R KW - *Cord Blood Stem Cell Transplantation/ae [Adverse Effects] KW - *Opportunistic Infections/ep [Epidemiology] KW - *Toxoplasma/ip [Isolation & Purification] KW - *Toxoplasmosis/ep [Epidemiology] KW - Adolescent KW - Adult KW - Child KW - Cytomegalovirus Infections/co [Complications] KW - Cytomegalovirus Infections/ep [Epidemiology] KW - Female KW - Graft vs Host Disease/ep [Epidemiology] KW - Humans KW - Male KW - Middle Aged KW - Opportunistic Infections/mo [Mortality] KW - Opportunistic Infections/ps [Parasitology] KW - Toxoplasma/ge [Genetics] KW - Toxoplasmosis/mo [Mortality] KW - Toxoplasmosis/ps [Parasitology] KW - Young Adult AB - Toxoplasmosis is a devastating opportunistic infection that can affect immunocompromised patients such as cord blood transplantation (CBT) recipients. The clinical characteristics of 4 toxoplasmosis CBT patients treated at our institution are reviewed, together with 5 cases collected from the literature. The rate of toxoplasmosis in our hospital was 6% in CBT recipients and 0.2% in other types of allogeneic hematopoietic stem cell transplantation (P < 0.001). Five patients (56%) presented disseminated toxoplasmosis and 4 patients (44%) had localized infection in the central nervous system. In 5 of the 9 patients considered (56%), cytomegalovirus viral replication had been detected before the clinical onset of toxoplasmosis. Seven patients (78%) had previously developed graft-versus-host disease. All patients who exhibited disseminated disease died due to Toxoplasma infection. Pre-transplant serology was positive in 1 patient, negative in 3 patients, and not performed in another. Only 1 of these 5 patients with disseminated disease had received Toxoplasma prophylaxis with cotrimoxazole. It could be concluded that mortality in CBT patients with disseminated toxoplasmosis is unacceptably high. The negative results of serology in the majority of these cases, and its unspecific clinical presentation, makes diagnosis exceedingly difficult. Better diagnostic tests and prophylaxis strategy are needed in CBT recipients.Copyright © 2012 John Wiley & Sons A/S. M1 - d1d, 100883688 CY - Denmark VL - 14 SN - 1399-3062 CP - 5 N1 - Comment in: Transpl Infect Dis. 2013 Jun;15(3):E124-5; PMID: 23534405, Comment in: Transpl Infect Dis. 2013 Jun;15(3):E126-7; PMID: 23534378 L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=medl&NEWS=N&AN=22548804 ID - 4475 ER -