- by ProfRN4 Jan 11, '05i searched the threads, but didn't really find the answer. one of our post bmt pts developed toxoplasmosis lesions in the brain. i believe he was all (possibly with cns relapse, don't remember), who came from another country. what's that about? how is this acquired? what is the prognosis?
- Jan 11, '05 by jaimealmostRNFrom working at a vet office in high school (and the tiny bit we learned in school) toxoplasmosis can be aquired from cat feces (litterboxes) when the cat is infected which can be common. A vet can do a quick blood test to determine this and we did them a lot esp. with a pregnant woman in the house. I'm pretty sure that it can be caught thru other vectors as well, but immunocompormised pts are most at risk (chemo, AIDS).
Oh wait, here's a fact sheet...it can be in the water too. Hope this helps.
- Jan 11, '05 by leslie :-Dtoxoplasmosis i believe to be a parasitic infection with the focus being on pregnant woman and kitty litter....it's contracted in other countries but that's all i know. just google toxoplasmosis and you will get a wealth of information.
i just don't know how much info you will get in regards to the infection of the brain lesions.....
much luck to you.
- Jan 11, '05 by NRSKarenRNThey may have been exposed and treated but relapsed.
Googled Toxoplasma + brain lesions, much info
- Jan 11, '05 by ProfRN4i knew about the cat litter (every person that i had contact with during my pregnancy was sure to remind me of this ). i'm guessing the raw/contaminated meat or water may be the culprit. we don't allow home-cooked food for a period after transplant (or fast food either ). after the anc keeps a steady incline the docs will allow it. this may have been the case. or somebody's water is no good :uhoh21: i'm also guessing maybe something from his country of origin (questionable living conditions?)
- Jan 17, '05 by nesherI'm quoting from Blood and marrow stem cell transplantation by Whedon and Wujcik. "Once identifed as a parasitic pathogen, Toxoplasma gondi has been reclassifed as a protozoan. After acute infection, a competent immune system maintains cysts of T, gondii, which persist in the CNS in a dormant state. Under conditions of immunospuression resulting from BMT, the organism may be reactivated. Left untreated, the organism is fatal in vitually 100% of cases.
Despite the fact that greater than 50% of the US population may be carriers, significant infection with this orgainsim is rare. It is hypothesied that Pneumocystis carinii prophylaxis pretransplantation may also prtoect pateints from reactivation of the latent toxoplasma infection. Combination therapy wtih pyrimethamine and sulfadiazine has been effective in treating acute toxoplama infection." (p.330)
Hope this helps clear up the issue. When your pateint goes home, teaching about avoiding the litter box and xate feces as well as information on dietary issues should be covered.
- Jan 18, '05 by ProfRN4thanks for the info. i'm not so sure he's going to make it home . all our kids get pcp prophylaxis before transplant, and again 30 days post (usually with pentamidine monthly). he's way past 30 days, so i'm sure he was gettting the pentam again. he's in the picu now, so i'm not too sure what's going on with him.
what i don't get is this: when i was pregnant, my ob (who was neurotic about everything) told me that toxoplasmosis is not as easy to get as one would think. at the time i had four cats . she said if they are indoor cats, and if i had had them for a significant period of time, i've probably developed an immunity to it. so is this ignorance on everyone elses part, or my ob?
- Jan 18, '05 by nesherWell I don't know if your OB is ignorant. If half of the US population are carriers it perhaps makes sense that until your immune system is in the toilet ( BMT or AIDS/HIV or certain drugs) than you should be OK. I guess I would ask you BMT docs about that one - they should be up to date on the recent literature.