International Journal of Hematology

, Volume 104, Issue 6, pp 729–740 | Cite as

Clinical characteristics and computed tomography findings of pulmonary toxoplasmosis after hematopoietic stem cell transplantation

  • Masahiko SumiEmail author
  • Kazumi Norose
  • Kenji Hikosaka
  • Hiroko Kaiume
  • Wataru Takeda
  • Takehiko Kirihara
  • Taro Kurihara
  • Keijiro Sato
  • Toshimitsu Ueki
  • Yuki Hiroshima
  • Hiroshi Kuraishi
  • Masahide Watanabe
  • Hikaru Kobayashi
Original Article


The prognosis of pulmonary toxoplasmosis, including disseminated toxoplasmosis involving the lungs, following hematopoietic stem cell transplantation (HSCT) is extremely poor due to the difficulties associated with early diagnosis and the rapidly progressive deterioration of multiorgan function. In our institution, we identified nine cases of toxoplasmosis, representing incidences of 2.2 and 19.6 % among all HSCT recipients and seropositive HSCT recipients, respectively. Of the patients with toxoplasmosis, six had pulmonary toxoplasmosis. Chest computed tomography (CT) findings revealed centrilobular, patchy ground-glass opacities (n = 3), diffuse ground-glass opacities (n = 2), ground-glass opacities with septal thickening (n = 1), and marked pleural effusion (n = 1). All cases died, except for one with suspected pulmonary toxoplasmosis who was diagnosed by a polymerase chain reaction assay 2 days after the onset of symptoms. In pulmonary toxoplasmosis, CT findings are non-specific and may mimic pulmonary congestion, atypical pneumonia, viral pneumonitis, and bronchopneumonia. Early diagnosis and treatment is crucial for overcoming this serious infectious complication. Pulmonary toxoplasmosis should be considered during differential diagnosis in a recipient with otherwise unexplained signs of infection and CT findings with ground-glass opacities, regardless of the distribution.


Toxoplasma gondii Pulmonary toxoplasmosis Disseminated toxoplasmosis Stem cell transplantation 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Japanese Society of Hematology 2016

Authors and Affiliations

  • Masahiko Sumi
    • 1
    Email author
  • Kazumi Norose
    • 2
  • Kenji Hikosaka
    • 2
  • Hiroko Kaiume
    • 1
  • Wataru Takeda
    • 1
  • Takehiko Kirihara
    • 1
  • Taro Kurihara
    • 1
  • Keijiro Sato
    • 1
  • Toshimitsu Ueki
    • 1
  • Yuki Hiroshima
    • 1
  • Hiroshi Kuraishi
    • 3
  • Masahide Watanabe
    • 4
  • Hikaru Kobayashi
    • 1
  1. 1.Department of HematologyNagano Red Cross HospitalNagano CityJapan
  2. 2.Department of Infection and Host Defense, Graduate School of MedicineChiba UniversityChibaJapan
  3. 3.Respiratory DivisionNagano Red Cross HospitalNagano CityJapan
  4. 4.Department of PathologyNagano Red Cross HospitalNagano CityJapan

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