Case Report: Immune Dysregulation Due to Reactivation After Allogeneic Hematopoietic Cell Transplant.

TitleCase Report: Immune Dysregulation Due to Reactivation After Allogeneic Hematopoietic Cell Transplant.
Publication TypeJournal Article
Year of Publication2021
AuthorsLindell RB, Wolf MS, Alcamo AM, Silverman MA, Dulek DE, Otto WR, Olson TS, Kitko CL, Paueksakon P, Chiotos K
JournalFront Pediatr
Volume9
Pagination719679
Date Published2021
ISSN2296-2360
Abstract

Disseminated toxoplasmosis is an uncommon but highly lethal cause of hyperferritinemic sepsis after hematopoietic cell transplantation (HCT). We report two cases of disseminated toxoplasmosis from two centers in critically ill adolescents after HCT: a 19-year-old who developed fever and altered mental status on day +19 after HCT and a 20-year-old who developed fever and diarrhea on day +52 after HCT. Both patients developed hyperferritinemia with multiple organ dysfunction syndrome and profound immune dysregulation, which progressed to death despite maximal medical therapies. Because disseminated toxoplasmosis is both treatable and challenging to diagnose, it is imperative that intensivists maintain a high index of suspicion for infection when managing immunocompromised children, particularly in those with known positive serologies.

DOI10.3389/fped.2021.719679
Alternate JournalFront Pediatr
PubMed ID34447731
PubMed Central IDPMC8382793