TY - JOUR T1 - Correlation of parasite load determined by quantitative PCR to clinical outcome in a heart transplant patient with disseminated toxoplasmosis JF - J Clin Microbiol Y1 - 2010 A1 - Patrat-Delon,S. A1 - Gangneux,J. P. A1 - Lavoue,S. A1 - Lelong,B. A1 - Guiguen,C. A1 - le Tulzo,Y. A1 - Robert-Gangneux,F. KW - *Toxoplasma / genetics / isolation & purification KW - Animals KW - Anti-Infective Agents / therapeutic use KW - Antibodies, Protozoan KW - DNA, Protozoan / *analysis KW - Heart Transplantation KW - Humans KW - Immunosuppression / adverse effects KW - Male KW - Mice KW - Middle Aged KW - Polymerase Chain Reaction / *methods KW - Toxoplasmosis / *diagnosis / drug therapy / parasitology KW - Trimethoprim-Sulfamethoxazole Combination / therapeutic use AB - Disseminated toxoplasmosis is a life-threatening infection in transplant recipients, which results either from reactivation of latent infection or from organ-transmitted primary infection. Preventive measures and diagnostic screening methods differ between countries and are related to the seroprevalence of Toxoplasma spp. in the general population. Here we report a case of disseminated toxoplasmosis in a heart transplant recipient with previous immunity that occurred after cotrimoxazole prophylaxis for the prevention of Pneumocystis jirovecii pneumonia was stopped. Quantitative PCR proved useful for the diagnosis and monitoring of Toxoplasma infection. Decreasing parasitic burdens in sequential samples of cerebrospinal fluid, blood, and bronchoalveolar lavage fluid correlated with a favorable outcome and allowed modulation of the immunosuppressive drug regimen. The duration of anti-Toxoplasma treatment and the need for maintenance prophylaxis are discussed, as well as prophylaxis for solid-organ transplant recipients. Although a rare event in heart transplant recipients, Toxoplasma reactivation must be investigated promptly, since early treatment improves the prognosis. VL - 48 CP - 7 N1 - Patrat-Delon, Solene Gangneux, Jean-Pierre Lavoue, Sylvain Lelong, Bernard Guiguen, Claude U2 - 2897503 ID - 1151 ER -