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Cutaneous toxoplasmosis.

W H Leyva, D J Santa Cruz

    Journal of the American Academy of Dermatology
    |April 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    This case report details a rare instance of epidermotropic cutaneous toxoplasmosis in a leukemia patient post-bone marrow transplant. The infection manifested as purpuric nodules, with Toxoplasma gondii found in skin cells.

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    Area of Science:

    • Medical Mycology
    • Dermatology
    • Hematology

    Background:

    • A 53-year-old male with chronic myelogenous leukemia (CML) in blast crisis underwent a bone marrow allograft.
    • The patient experienced persistent severe pancytopenia post-transplantation.

    Observation:

    • Twenty-one days after the transplant, diffuse, palpable, purpuric nodules emerged on the skin.
    • Parasites, identified as Toxoplasma gondii via ultrastructural analysis, were observed within epidermal keratinocytes, both singly and in cysts.
    • Infiltration of dermal and neural tissues by the parasite was also noted.

    Findings:

    • The case presents epidermotropic cutaneous toxoplasmosis, a rare manifestation of Toxoplasma gondii infection.
    • The presence of the parasite in epidermal keratinocytes and its infiltration into dermal and neural tissues are key findings.

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  • The patient's immunocompromised state following bone marrow transplantation likely contributed to the infection's severity and presentation.

    • Implications:

    • This case highlights the potential for severe opportunistic infections like toxoplasmosis in immunocompromised patients, particularly after bone marrow transplantation.
    • Possible sources of infection include reactivation of latent toxoplasmosis, transmission via the allograft, or nosocomial acquisition, necessitating careful donor screening and patient monitoring.
    • The findings underscore the importance of considering toxoplasmosis in the differential diagnosis of cutaneous lesions in transplant recipients with unexplained symptoms.