Abstract
Toxoplasmosis is a well-recognized opportunistic disease in HIV-infected individuals that is caused by the reactivation of a previous infection, primarily in the central nervous system, during profound immunodeficiency. Toxoplasmosis has been described more rarely in patients with cancer and chemotherapy. We report a case of a patient with a history of chemotherapy for non-Hodgkin lymphoma who developed pain and progressive paresthesia of the right arm 6 weeks after remission. Relapsing lymphoma was suspected, and steroid and radiation treatment were initiated, but the patient died 5 days later due to multiple organ failure. Autopsy revealed disseminated toxoplasmosis. This case illustrates that toxoplasmosis should be suspected in patients with neoplastic disease, especially lymphomas, who present with unexplained neurologic, pulmonary, or febrile symptoms during or after chemotherapy.
References
Montoya JG, Liesenfeld O: Toxoplasmosis. Lancet 2004; 363: 1965–1976.
Gleason TH, Hamlin WB: Disseminated toxoplasmosis in the compromised host. A report of five cases. Arch Intern Med 1974; 134: 1059–1062.
Vietzke WM, Gelderman AH, Grimley PM, Valsamis MP: Toxoplasmosis complicating malignancy. Experience at the National Cancer Institute. Cancer 1968; 21: 816–827.
Carey RM, Kimball AC, Armstrong D, Lieberman PH: Toxoplasmosis. Clinical experiences in a cancer hospital. Am J Med 1973; 54: 30–38.
Foss FM, Ihde DC, Linnoila IR, Fischmann AB, Schechter GP, Cotelingam JD, Steinberg SM, Ghosh BC, Stocker JL, Bastian A, et al. Phase II trial of fludarabine phosphate and interferon alfa-2a in advanced mycosis fungoides/Sezary syndrome. J Clin Oncol 1994; 12: 2051–2059.
Bacchu S, Fegan C, Neal J: Cerebral toxoplasmosis in a patient with chronic lymphocytic leukaemia treated with fludarabine. Br J Haematol 2007; 139: 349.
Israelski DM, Remington JS: Toxoplasmosis in patients with cancer. Clin Infect Dis 1993; 17: S423–S435.
Dupon M, Cazenave J, Pellegrin JL, Ragnaud JM, Cheyrou A, Fischer I, Leng B, Lacut JY: Detection of Toxoplasma gondii by PCR and tissue culture in cerebrospinal fluid and blood of human immunodeficiency virus-seropositive patients. J Clin Microbiol 1995; 33: 2421–2426.
Vidal JE, Colombo FA, de Oliveira AC, Focaccia R, Pereira-Chioccola VL: PCR assay using cerebrospinal fluid for diagnosis of cerebral toxoplasmosis in Brazilian AIDS patients. J Clin Microbiol 2004; 42: 4765–4768.
Goto M, Takahashi T, Kanda T, Iwamoto A: Detection of Toxoplasma gondii by polymerase chain reaction in cerebrospinal fluid from human immunodeficiency virus-1-infected Japanese patients with focal neurological signs. J Int Med Res 2004; 32: 665–670.
Adurthi S, Sahoo T, Chakka K, Radhika B, Appaji L, Bapsy P, Ramesh C, Jayshree R: Acute toxoplasmosis in nonstem cell transplant patients with haematological malignancies: a study from a regional cancer institute in South India. Hematol Oncol 2008; 26: 229–233.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Herold, M.A., Kühne, R., Vosberg, M. et al. Disseminated Toxoplasmosis in a Patient with Non-Hodgkin Lymphoma. Infection 37, 551–554 (2009). https://doi.org/10.1007/s15010-009-9007-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-009-9007-5