Toxoplasmosis in a post-transplant bronchoalveolar lavage: A case report

Sara E. Monaco, Sara A. Monaghan, Jason A. Stamm, Walid E. Khalbuss, Larry Nichols, Liron Pantanowitz

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Toxoplasma gondii usually causes an asymptomatic and then latent infection in human adults; however, a potentially fatal disseminated form can occur in immunocompromised patients. Given that the diagnosis of acute Toxoplasma infection, as opposed to latent disease, relies on finding direct evidence of T. gondii infection in tissue, pathologic examination is critical. There have only been a few reports describing the cytomorphology of Toxoplasma in exfoliative cytology, and no reports of the findings in Thin Prep. In this report, we describe a fatal case of toxoplasmosis in a cardiac transplant patient that was diagnosed by respiratory cytopathology. Although the extracellular organisms were well visualized on the Wright-Giemsa stained cytospin, they were only faintly seen on the Pap-stained cytospin trapped within mucin and were not easily appreciated on the ThinPrep slides nor the H&E stained cell block sections. An immunohistochemical stain for Toxoplasma performed on the cell block was strongly positive, and an autopsy performed on the patient confirmed disseminated infection. Our case illustrates that the diagnosis of Toxoplasma in exfoliative cytology specimens can be challenging since organisms are not well visualized on ThinPrep or Pap-stained material; therefore, Wright-Giemsa stained material can be particularly helpful.

Original languageEnglish (US)
Pages (from-to)629-634
Number of pages6
JournalDiagnostic cytopathology
Volume40
Issue number7
DOIs
StatePublished - Jul 1 2012

Keywords

  • Toxoplasma gondii
  • bronchoalveolar lavage
  • cytology
  • toxoplasmosis
  • transplant

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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  • Cite this

    Monaco, S. E., Monaghan, S. A., Stamm, J. A., Khalbuss, W. E., Nichols, L., & Pantanowitz, L. (2012). Toxoplasmosis in a post-transplant bronchoalveolar lavage: A case report. Diagnostic cytopathology, 40(7), 629-634. https://doi.org/10.1002/dc.21646