Cutaneous toxoplasmosis

A case of epidermotropic cutaneous toxoplasmosis is reported. The patient, a 53-year-old man with chronic myelogenous leukemia in blast crisis, received a bone marrow allograft but continued to have severe pancytopenia. Numerous diffuse, palpable, purpuric nodules appeared 21 days after the transplant. Organisms were found within the epidermal keratinocytes--both singularly and in cysts. Dermal and neural infiltration was also present. Toxoplasma gondii was identified on the basis of the ultrastructural features of the parasite. Possible sources of infection include reactivation of a previous latent infection, transmission through a bone marrow allograft, or nosocomial acquisition.