S. Okamoto et al., TRICHOMONAS FETUS MENINGOENCEPHALITIS AFTER ALLOGENEIC PERIPHERAL-BLOOD STEM-CELL TRANSPLANTATION, Bone marrow transplantation, 21(1), 1998, pp. 89-91
A 34-year-old man with refractory acute myelogenous leukemia underwent
allogeneic peripheral blood stem cell transplantation (PBSCT) from hi
s HLA-matched sibling, Engraftment was prompt and no acute GVHD develo
ped, However, high fever persisted even after engraftment, and the pat
ient developed headache, diplopia, vertigo and nuchal rigidity on day
20 posttransplant, Cerebrospinal fluid (CSF) showed pleocytosis with n
o detectable microorganisms, Despite therapy with broad-spectrum antib
iotics, antifungal agents and antituberculous drugs, he developed rapi
d mental deterioration with seizures and died on day 40, Just prior to
his death, trichomonads were isolated from both CSF and urine, Scanni
ng electron microscopic examination identified the trichomonad as Tric
homonas foetus. At autopsy, trichomonads were detected histopathologic
ally in an area involving meningoencephalitis. To our knowledge, this
is the first case of T. foetus meningoencephalitis in a recipient of a
llogeneic PBSCT and, more importantly, the first human case of T. foet
us infection.