Acute toxoplasma dissemination with encephalitis in the era of biological therapies

Abstract

We report the case of a 65-year-old patient with pseudolymphoma who developed acute toxoplasmosis following 6 cycles of rituximab and bendamustine therapy. Acute toxoplasmosis in the setting of biological response modifiers, rather than reactivation, is a unique unreported infection. The patient developed severe disease with multi-organ involvement, including retinitis, myocarditis, and myositis. We discuss the clinical findings, epidemiology, and laboratory diagnosis. © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/

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Keywords

Biological therapy, Encephalitis, Rituximab, Toxoplasma gondii, Toxoplasmosis, Wild boar, Abatacept, Bendamustine, Cotrimoxazole, Immunoglobulin g, Immunoglobulin m, Trametinib, Adult, Article, Case report, Cell proliferation, Cerebrospinal fluid analysis, Clinical article, Dyspnea, Echocardiography, Enzyme linked immunosorbent assay, Eye examination, Eye swelling, Human, Leg pain, Male, Middle aged, Multiple cycle treatment, Myocarditis, Myositis, Nuclear magnetic resonance imaging, Pleocytosis, Polymerase chain reaction, Priority journal, Pseudolymphoma, Radiation dose, Retinitis, Rheumatoid arthritis

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