Adverse Occurrence type:
12 of 1979 cases (0.61%) in a multicentre, matched case-control, study in Spain.
Time to detection:
12 - 22 days
Alerting signals, symptoms, evidence of occurrence:
Fever is the commonest onset symptom. Abdominal pain, diarrhea, dry cough, pneumonitis, rash, lymphadenopathy, myocarditis, CNS symptoms. Latency may be modified/extended by prophylaxis. Trimethoprim-Sulfamethoxazole (TMP-SMX) prophylaxis (used for Pneumocystis prophylaxis) prevents or mitigates the effects of toxoplasma infection. Organ transmitted infection is more often associated with acute (severe) disease than reactivation.
Demonstration of imputability or root cause:
Imputability based on donor seropositive/recipient seronegative mismatch followed by seroconversion in the early post transplant period. Toxoplasma gondii cysts found in myocardium. Many more cases reported where possible imputability cannot be ascertained or reactivation was much more likely.