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Reference Manager
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1.
Bossi P, Bricaire F, 2004. Severe acute disseminated toxoplasmosis. Lancet 364: 579.
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2.
Rouphael NG, Talati NJ, Vaughan C, Cunningham K, Moreira R, Gould C, 2007. Infections associated with hemophagocytic syndrome. Lancet Infect Dis 7: 814–822.
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3.
Guillaume MP, Driessens N, Libert M, De Bels D, Corazza F, Karmali R, 2006. Hemophagocytic syndrome associated with extracerebral toxoplasmosis in an HIV-infected patient. Eur J Intern Med 17: 503–504.
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4.
Blanche P, Robert F, Dupouy-Camet J, Sicard D, 1994. Toxoplasmosis-associated hemophagocytic syndrome in a patient with AIDS: diagnosis by the polymerase chain reaction. Clin Infect Dis 19: 989–990.
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5.
Karras A, Thervet E, Legendre C, 2004. Hemophagocytic syndrome in renal transplant recipients: report of 17 cases and review of literature. Transplantation 77: 238–243.
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6.
Duband S, Cornillon J, Tavernier E, Dumollard JM, Guyotat D, Péoc'h M, 2008. Toxoplasmosis with hemophagocytic syndrome after bone marrow transplantation: diagnosis at autopsy. Transpl Infect Dis 10: 372–374.
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7.
Homan WL, Vercammen M, De Braekeleer J, Verschueren H, 2000. Identification of a 200- to 300-fold repetitive 529 bp DNA fragment in Toxoplasma gondii, and its use for diagnostic and quantitative PCR. Int J Parasitol 30: 69–75.
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8.
Xiao Y, Yin JG, Jiang N, Xiang M, Hao LL, Lu HJ, Sang H, Liu XY, Xu HJ, Ankarklev J, Lindh J, Chen QJ, 2001. Seroepidemiology of human Toxoplasma gondii infection in China. BMC Infect Dis 10: 4.
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9.
Montoya JG, Liesenfeld O, 2004. Toxoplasmosis. Lancet 363: 1965–1976.
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10.
Habek M, Ozretić D, Zarković K, Djaković V, Mubrin Z, 2009. Unusual cause of dementia in an immunocompetent host: toxoplasmic encephalitis. Neurol Sci 30: 45–49.
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11.
Pergola G, Cascone A, Russo M, 2010. Acute pericarditis and myocarditis by Toxoplasma gondii in an immunocompetent young man: a case report. Infez Med 18: 48–52.
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12.
Nunura J, Vásquez T, Endo S, Salazar D, Rodriguez A, Pereyra S, Solis H, 2010. Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon. Rev Inst Med Trop Sao Paulo 52: 107–110.
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13.
Henter JI, Elinder G, Ost A, 1991. Diagnostic guidelines for hemophagocytic lymphohistiocytosis. The FHL Study Group of the Histiocyte Society. Semin Oncol 18: 29–33.
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14.
Henter JI, Horne A, Aricó M, Egeler RM, Filipovich AH, Imashuku S, Ladisch S, McClain K, Webb D, Winiarski J, Janka G, 2007. HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 48: 124–131.
-
15.
Briand PY, Gangneux JP, Favaretto G, Ly-Sunnaram B, Godard M, Robert-Gangneux F, Fest T, 2008. Hemophagocytic syndrome and toxoplasmic primo-infection. Ann Biol Clin (Paris) 66: 199–205.
-
16.
Barbosa CJ, Molina RJ, de Souza MB, Silva AC, Micheletti AR, dos Reis MA, de Paula Antunes Teixeira V, Silva-Vergara ML, 2007. Disseminated toxoplasmosis presenting as sepsis in two AIDS patients. Rev Inst Med Trop Sao Paulo 49: 113–116.
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Lucet JC, Bailly MP, Bedos JP, Wolff M, Gachot B, Vachon F, 1993. Septic shock due to toxoplasmosis in patients infected with the human immunodeficiency virus. Chest 104: 1054–1058.
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Su C, Shwab EK, Zhou P, Zhu XQ, Dubey JP, 2010. Moving towards an integrated approach to molecular detection and identification of Toxoplasma gondii. Parasitology 137: 1–11.
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Dubey JP, Jones JL, 2008. Toxoplasma gondii infection in humans and animals in the United States. Int J Parasitol 38: 1257–1278.
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Tenter AM, Heckeroth AR, Weiss LM, 2000. Toxoplasma gondii: from animals to humans. Int J Parasitol 30: 1217–1258.
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Hemophagocytic Syndrome as Uncommon Presentation of Disseminated Toxoplasmosis in an Immunocompetent Adult from Chinese Kunming
YanFen Yang
YanFen Yang
Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China; Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China; Department of Biology, Wake Forest University, Winston-Salem, North Carolina
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WeiWei Zuo
WeiWei Zuo
Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China; Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China; Department of Biology, Wake Forest University, Winston-Salem, North Carolina
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JunJie Hu
JunJie Hu
Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China; Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China; Department of Biology, Wake Forest University, Winston-Salem, North Carolina
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Gerald W. Esch
Gerald W. Esch
Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China; Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China; Department of Biology, Wake Forest University, Winston-Salem, North Carolina
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YangXian Zuo
YangXian Zuo
Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China; Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China; Department of Biology, Wake Forest University, Winston-Salem, North Carolina
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Hemophagocytic syndrome is a rare disease that is often fatal, despite treatment. An immunocompetent patient was presented with fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia, which conformed to a hemophagocytic syndrome diagnosis. Despite broad antibiotic treatment, the patient's clinical condition rapidly deteriorated and he died within 8 days of admission. Blood cultures and a serology test were negative; however, based on morphological characteristics, tissue cysts Toxoplasma gondii were found in the bone marrow. Based on polymerase chain reaction analysis, identity of the parasite was confirmed. Although very rare, T. gondii-associated hemophagocytic syndrome should be suspected in the case of cytopenia or multiorgan failure symptoms. To our knowledge, this is the first fatal toxoplasmosis case reported from China.
Author Notes
Financial support: This work was partly supported by the Natural Sciences Foundation of China (grant 30770257).
Authors' addresses: YanFen Yang, JunJie Hu, and YangXian Zuo, Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China, E-mails: 12011000936@mail.ynu.edu.cn, jjhu@ynu.edu.cn, and xwchen@ynu.edu.cn. WeiWei Zuo, Clinical Laboratory, First Affiliated Hospital of Kunming Medical University, Kunming, China, E-mail: 277412741@qq.com.cn. Gerald W. Esch, Department of Biology, Wake Forest University, Winston-Salem, NC, E-mail: esch@wfu.edu.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Bossi P, Bricaire F, 2004. Severe acute disseminated toxoplasmosis. Lancet 364: 579.
-
2.
Rouphael NG, Talati NJ, Vaughan C, Cunningham K, Moreira R, Gould C, 2007. Infections associated with hemophagocytic syndrome. Lancet Infect Dis 7: 814–822.
-
3.
Guillaume MP, Driessens N, Libert M, De Bels D, Corazza F, Karmali R, 2006. Hemophagocytic syndrome associated with extracerebral toxoplasmosis in an HIV-infected patient. Eur J Intern Med 17: 503–504.
-
4.
Blanche P, Robert F, Dupouy-Camet J, Sicard D, 1994. Toxoplasmosis-associated hemophagocytic syndrome in a patient with AIDS: diagnosis by the polymerase chain reaction. Clin Infect Dis 19: 989–990.
-
5.
Karras A, Thervet E, Legendre C, 2004. Hemophagocytic syndrome in renal transplant recipients: report of 17 cases and review of literature. Transplantation 77: 238–243.
-
6.
Duband S, Cornillon J, Tavernier E, Dumollard JM, Guyotat D, Péoc'h M, 2008. Toxoplasmosis with hemophagocytic syndrome after bone marrow transplantation: diagnosis at autopsy. Transpl Infect Dis 10: 372–374.
-
7.
Homan WL, Vercammen M, De Braekeleer J, Verschueren H, 2000. Identification of a 200- to 300-fold repetitive 529 bp DNA fragment in Toxoplasma gondii, and its use for diagnostic and quantitative PCR. Int J Parasitol 30: 69–75.
-
8.
Xiao Y, Yin JG, Jiang N, Xiang M, Hao LL, Lu HJ, Sang H, Liu XY, Xu HJ, Ankarklev J, Lindh J, Chen QJ, 2001. Seroepidemiology of human Toxoplasma gondii infection in China. BMC Infect Dis 10: 4.
-
9.
Montoya JG, Liesenfeld O, 2004. Toxoplasmosis. Lancet 363: 1965–1976.
-
10.
Habek M, Ozretić D, Zarković K, Djaković V, Mubrin Z, 2009. Unusual cause of dementia in an immunocompetent host: toxoplasmic encephalitis. Neurol Sci 30: 45–49.
-
11.
Pergola G, Cascone A, Russo M, 2010. Acute pericarditis and myocarditis by Toxoplasma gondii in an immunocompetent young man: a case report. Infez Med 18: 48–52.
-
12.
Nunura J, Vásquez T, Endo S, Salazar D, Rodriguez A, Pereyra S, Solis H, 2010. Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon. Rev Inst Med Trop Sao Paulo 52: 107–110.
-
13.
Henter JI, Elinder G, Ost A, 1991. Diagnostic guidelines for hemophagocytic lymphohistiocytosis. The FHL Study Group of the Histiocyte Society. Semin Oncol 18: 29–33.
-
14.
Henter JI, Horne A, Aricó M, Egeler RM, Filipovich AH, Imashuku S, Ladisch S, McClain K, Webb D, Winiarski J, Janka G, 2007. HLH-2004: diagnostic and therapeutic guidelines for hemophagocytic lymphohistiocytosis. Pediatr Blood Cancer 48: 124–131.
-
15.
Briand PY, Gangneux JP, Favaretto G, Ly-Sunnaram B, Godard M, Robert-Gangneux F, Fest T, 2008. Hemophagocytic syndrome and toxoplasmic primo-infection. Ann Biol Clin (Paris) 66: 199–205.
-
16.
Barbosa CJ, Molina RJ, de Souza MB, Silva AC, Micheletti AR, dos Reis MA, de Paula Antunes Teixeira V, Silva-Vergara ML, 2007. Disseminated toxoplasmosis presenting as sepsis in two AIDS patients. Rev Inst Med Trop Sao Paulo 49: 113–116.
-
17.
Lucet JC, Bailly MP, Bedos JP, Wolff M, Gachot B, Vachon F, 1993. Septic shock due to toxoplasmosis in patients infected with the human immunodeficiency virus. Chest 104: 1054–1058.
-
18.
Su C, Shwab EK, Zhou P, Zhu XQ, Dubey JP, 2010. Moving towards an integrated approach to molecular detection and identification of Toxoplasma gondii. Parasitology 137: 1–11.
-
19.
Dubey JP, Jones JL, 2008. Toxoplasma gondii infection in humans and animals in the United States. Int J Parasitol 38: 1257–1278.
-
20.
Tenter AM, Heckeroth AR, Weiss LM, 2000. Toxoplasma gondii: from animals to humans. Int J Parasitol 30: 1217–1258.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 345 | 235 | 25 |
| Full Text Views | 289 | 4 | 0 |
| PDF Downloads | 72 | 7 | 0 |