Toxoplasma gondii-induced brachial plexus neuropathy after allogeneic hematopoietic stem cell transplantation

Transpl Infect Dis. 2019 Oct;21(5):e13157. doi: 10.1111/tid.13157. Epub 2019 Aug 24.

Abstract

Brachial plexus neuropathy is a rare, but underdiagnosed condition, characterized by intense analgesic-resistant shoulder pain, followed by brachial plexus paresis and sensory symptoms. We present a case of brachial plexus neuropathy, induced by Toxoplasma gondii (T. gondii) 17 days after allogeneic hematopoietic stem cell transplantation (alloHSCT) in a patient with acute myeloid leukemia. The diagnosis was made based on the clinical presentation, magnetic resonance imaging (MRI) of the brachial plexus, and positive T. gondii polymerase chain reaction (PCR) in cerebrospinal fluid. The patient was treated with pyrimethamine, sulfadiazine, and levofolinic acid during 6 weeks, with a positive outcome.

Keywords: Toxoplasma gondii; allogeneic hematopoietic stem cell transplantation; brachial plexus neuropathy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Brachial Plexus / diagnostic imaging
  • Brachial Plexus / parasitology
  • Brachial Plexus Neuropathies / diagnostic imaging*
  • Brachial Plexus Neuropathies / parasitology*
  • Female
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Magnetic Resonance Imaging
  • Toxoplasma / genetics
  • Toxoplasmosis / complications
  • Toxoplasmosis / diagnosis*
  • Transplantation, Homologous / adverse effects*