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Bone-marrow transplantation and toxoplasmic retinochoroiditis
Summary
Toxoplasma gondii caused necrotizing retinitis in an immunocompromised patient post-bone marrow transplant. This opportunistic infection highlights the need to consider toxoplasmosis in differential diagnoses for severe eye conditions in immunosuppressed individuals.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Hematology
Background:
- A 33-year-old patient with chronic myelocytic leukemia (CML) underwent bone marrow transplantation.
- Immunosuppressive therapy was administered for graft-versus-host disease prophylaxis.
Observation:
- Five months post-transplant, the patient developed rapidly progressing necrotizing retinitis in both eyes.
- The patient succumbed to pneumonia secondary to her immunosuppressed state.
Findings:
- Postmortem examination revealed Toxoplasma gondii infection in the retina, brain, and myocardium.
- Toxoplasmic cysts were identified in both necrotic and adjacent intact retinal tissues, with minimal inflammation.
Implications:
- Toxoplasmosis should be considered in the differential diagnosis of necrotizing retinochoroiditis in immunocompromised patients.
- This case underscores the risk of opportunistic infections, such as toxoplasmosis, in individuals undergoing transplantation and immunosuppression.