A Report of Two Cases of Cerebral Toxoplasmosis in Leukemia Patients

Introduction:: Toxoplasmosis is a parasitic infection cause by Toxoplasma gondii. This parasite is associated with congenital infection and can cause abortion, encephalitis or systemic infection in immune- compromised patients. Case Presentation: In this study, two cases of central nervous system toxoplasmosis in leukemia patients are reported. The first case was a 15-year-old girl with acute lymphoblastic leukemia (ALL) who was using maintenance treatment for one year. The patient referred in 2010 to the hospital with headache, nausea and vomiting since three weeks ago. Brain magnetic resonance imaging (MRI) indicated a hypointense lesion in the left temporal compatible with cerebral toxoplasmosis. Serum immunoglobulin M (Ig M) rate against Toxoplasma was 8 and Ig G was 5 IU/mL. The patient was prescribed with pyrimethamin, sulfadiazine and lecoverin, but she was expired eight months after toxoplasmosis infection with bone marrow relapse in re- induction period of chemotherapy. The second case was a 6-year-old boy with acute myeloblastic leukemia (AML) diagnosed in 2010. The patient was on maintenance treatment. Two months ago, he was admitted to a hospital because of high temperature. In the brain MRI a 30 mm mass was revealed. Ig M antibody was more than 9 and Ig G was 6 IU/ mL. The patient received pyrimethamin, sulfadiazine and leucoverin. He is alive and has the neurologic sequel. Conclusions: Disseminated toxoplasmosis is a major health problem in immune- compromised patients, and it is necessary to examine the patients before, during and after chemotherapy for toxoplasmosis.