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Case Reports in Transplantation
Volume 2012, Article ID 524279, 3 pages
Case Report

Fatal Toxoplasma gondii Dissemination in a Heart Transplant Recipient: Description of a Case

1Department of Cardiovascular Surgery, University Hospital of Navarre, Avenida Pio XII, 31008 Pamplona, Spain
2Department of Cardiac Surgery, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada K1Y 4W7

Received 5 April 2012; Accepted 5 July 2012

Academic Editors: M. G. H. Betjes, C. Costa, J. Kaneko, F. Keller, and M. Klinger

Copyright © 2012 S. Mastrobuoni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 45-year-old heart transplant recipient presented with fever, anorexia, asthenia, and lethargy. She had received heart transplantation only 5 weeks earlier for primary systemic amyloidosis with severe cardiac involvement. Serum sodium was low, and tacrolimus through level was high. Blood cultures and serology tests for infection were negative, and atypical pneumonia was suspected. Despite broad antibiotic, antiviral, and antifungal treatment, the patient clinical condition rapidly deteriorated and she died within three days of admission. Postmortem examination revealed a disseminated Toxoplasma gondii infection as a result of donor (+)/recipient(−) mismatch for Toxoplasma serology. Although very rare, toxoplasmosis in heart transplant recipient should be suspect in case of neurological deficit and respiratory symptoms. Prophylaxis treatment is recommended in case of mismatch.