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Hemophagocytic Syndrome as Uncommon Presentation of Disseminated Toxoplasmosis in an Immunocompetent Adult from Chinese Kunming

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  • 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

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

* Address correspondence to JunJie Hu, Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming 650091, China. E-mail: jjhu@ynu.edu.cn

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.

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