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Parasitic Infections in Transplant Recipients: Toxoplasmosis, Strongyloidiasis, and Other Parasites

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Abstract

Toxoplasma gondii and Strongyloides stercoralis are important parasitic infections in transplant recipients. These helminths can lead to severe and often life-threatening disease in immunocompromised patients. Toxoplasma gondii can cause an undifferentiated febrile syndrome, encephalitis, pneumonitis, myocarditis, hepatitis, and retinochoroiditis, whereas S. stercoralis infestation, can lead to the hyperinfection syndrome, which carries a high mortality rate. Effective therapies are available for both, but high case-fatality rates result if these syndromes go unrecognized and are not treated promptly. Preventative measures for infected (and often asymptomatic) transplant recipients/candidates are highly effective in preventing overt disease for both parasites, including prophylactic anti-Toxoplasma therapy or ivermectin treatment for patients with occult strongyloidiasis in properly selected patients. Identifying transplant patients at risk for these syndromes is therefore critical, so that these measures can be instituted before life-threatening disease develops. Other important parasitic infections in transplant recipients include Trypanosoma cruzi (the agent of Chagas disease), visceral leishmaniasis, and the free-living amoebae Acanthamoeba and Balamuthia.

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Blackburn, B.G., Montoya, J.G. (2019). Parasitic Infections in Transplant Recipients: Toxoplasmosis, Strongyloidiasis, and Other Parasites. In: Safdar, A. (eds) Principles and Practice of Transplant Infectious Diseases. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-9034-4_46

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