Systemic toxoplasmosis in a cat under cyclosporine therapy

Toxoplasma gondii, an obligatory intracellular protozoan parasite infecting warm-blooded animals, can cause toxoplasmosis, a major zoonosis. A male neutered, domestic cat was referred to the Hebrew University Veterinary Teaching Hospital due to dyspnea after long term treatment with cyclosporine for obsessive self-grooming and pruritis. After thorough diagnostics, including non - invasive imaging, broncho-alveolar lavage, blood serology, hematology and biochemistry, and evaluation of the aspirated fluid components, a severe pneumonia and abdominal effusion were detected with observation of free tachyzoites under light microscopy from lavage fluids. PCR and DNA sequencing of broncho-alveolar lavage was positive for T. gondii. Despite aggressive treatment with antibiotics, oxygen supplementation and T. gondii specific antimicrobials, the cat died. It is suggested that potential candidates for cyclosporine be screened for T. gondii antibodies, kept entirely indoors and not fed uncooked meat in order to prevent exposure to T. gondii infection.