TOXOPLASMOSIS IN KIDNEY-TRANSPLANT RECIPIENTS - REPORT OF 6 CASES ANDREVIEW

Six patients with toxoplasmosis complicating renal transplantation are described, and 25 other reported cases are reviewed. The mean age of the 31 patients was 35.16 years. Most of the recipients (25 of 29) sho wed signs of toxoplasmosis within 3 months post-transplantation, with fever, neurological disturbances, and pneumonia as the main clinical f eatures. Diagnosis was established at autopsy in 15 cases, by serology in 13 cases, and by direct examination, culture, or polymerase chain reaction of biological samples in 5 cases. Seventeen patients also had concomitant infections. The donor was the likely source of transmissi on to 10 recipients; reactivation was suspected in two cases. The sour ce of transmission could not be determined for the remaining 19 patien ts. The mortality rate was 64.5%. Ten of the 11 patients given specifi c treatment survived, indicating that early diagnosis and therapy are essential.