Toxoplasmic encephalitis after allogeneic hematopoietic stem cell transplantation

Area of Science:

• Infectious Diseases
• Hematology
• Neurology

Background:

• Hematopoietic stem cell transplantation (HSCT) can lead to opportunistic infections.
• Cerebral toxoplasmosis is a rare but severe complication in immunocompromised patients post-HSCT.

Observation:

• A case of cerebral toxoplasmosis is presented in a patient with acute myeloid leukemia post-HSCT.
• Neurologic symptoms and brain lesions were observed.
• Diagnosis was confirmed via cerebrospinal fluid polymerase chain reaction (PCR) and cranial magnetic resonance imaging (MRI).

Findings:

• The patient received a combination of trimethoprim-sulfamethoxazole and clindamycin.
• Despite treatment, the patient succumbed to a nosocomial infection 15 days after initiating therapy.
• This highlights the critical nature of cerebral toxoplasmosis in the post-HSCT setting.

Implications:

• Cerebral toxoplasmosis must be considered in HSCT patients presenting with neurological symptoms and brain lesions.
• Polymerase chain reaction (PCR) offers a rapid and vital diagnostic method.
• Combined use of cranial imaging and PCR is recommended for timely and accurate diagnosis.