Generalized Toxoplasmosis Following Renal Transplantation

Abstract

ALTHOUGH.LTHOUGH toxoplasmosis is a common asymptomatic protozoan infection, as indicated by the prevalence of antitoxoplasma antibodies among the adult population,^1-3acute toxoplasmosis in normal adults is uncommon.^4-8Indeed, most reported cases have occurred in patients with either leukemia, cancer, or other chronic disease treated with antimetabolites, immunosuppressive agents, or corticosteroids.^9-15This report concerns a patient with chronic renal disease who was placed on an immunosuppressive regimen and who died of acute disseminated toxoplasmosis one month after receiving a renal homotransplant. Serologic studies suggest that primary infection with<i>Toxoplasma gondii</i>occurred at the time of transplantation. <h3>Report of Case</h3> M. C., a 20-year-old man, was admitted to the Peter Bent Brigham Hospital with uermia secondary to chronic glomerulonephritis. He was febrile due to bacterial pneumonia and peritonitis. The infection responded to antibiotics. During the next two months he remained afebrile. His severe, intractible uremia was treated by repeated