{"id":"https://openalex.org/W3009166006","doi":"https://doi.org/10.1016/j.clinpr.2020.100021","title":"Primary toxoplasmosis complicated by possible IRIS 15 years after renal transplantation","display_name":"Primary toxoplasmosis complicated by possible IRIS 15 years after renal transplantation","publication_year":2020,"publication_date":"2020-03-06","ids":{"openalex":"https://openalex.org/W3009166006","doi":"https://doi.org/10.1016/j.clinpr.2020.100021","mag":"3009166006"},"language":"en","primary_location":{"id":"doi:10.1016/j.clinpr.2020.100021","doi":"https://doi.org/10.1016/j.clinpr.2020.100021","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.clinpr.2020.100021","pdf_url":"https://www.sciencedirect.com/science/article/pii/S259017022030008X/pdf","source":{"id":"https://openalex.org/S4210170759","display_name":"Clinical Infection in Practice","issn_l":"2590-1702","issn":["2590-1702"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Infection in Practice","raw_type":"journal-article"},"parent_works":[],"lineage":["https://openalex.org/W3009166006"],"child_works_count":0,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://www.sciencedirect.com/science/article/pii/S259017022030008X/pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5067260773","display_name":"Allifia Abbas","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I200166805","display_name":"Guy's and St Thomas' NHS Foundation Trust","ror":"https://ror.org/00j161312","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I200166805"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Allifia Abbas","raw_affiliation_strings":["Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland","institution_ids":["https://openalex.org/I200166805"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5009920831","display_name":"Charlotte Zheng","orcid":"https://orcid.org/0000-0001-9963-4983","observed_orcids":["https://orcid.org/0000-0001-9963-4983"]},"institutions":[{"id":"https://openalex.org/I200166805","display_name":"Guy's and St Thomas' NHS Foundation Trust","ror":"https://ror.org/00j161312","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I200166805"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Charlotte Zheng","raw_affiliation_strings":["Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland","institution_ids":["https://openalex.org/I200166805"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5029090044","display_name":"Claire van Nispen tot Pannerden","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I200166805","display_name":"Guy's and St Thomas' NHS Foundation Trust","ror":"https://ror.org/00j161312","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I200166805"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Claire van Nispen tot Pannerden","raw_affiliation_strings":["Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland","institution_ids":["https://openalex.org/I200166805"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5027428397","display_name":"William Newsholme","orcid":"https://orcid.org/0000-0003-3845-9282","observed_orcids":["https://orcid.org/0000-0003-3845-9282"]},"institutions":[{"id":"https://openalex.org/I200166805","display_name":"Guy's and St Thomas' NHS Foundation Trust","ror":"https://ror.org/00j161312","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I200166805"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"William Newsholme","raw_affiliation_strings":["Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland","institution_ids":["https://openalex.org/I200166805"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5009032063","display_name":"Rachel M. Hilton","orcid":"https://orcid.org/0000-0001-5118-2017","observed_orcids":["https://orcid.org/0000-0001-5118-2017"]},"institutions":[{"id":"https://openalex.org/I200166805","display_name":"Guy's and St Thomas' NHS Foundation Trust","ror":"https://ror.org/00j161312","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I200166805"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Rachel Hilton","raw_affiliation_strings":["Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom of Great Britain and Northern Ireland","institution_ids":["https://openalex.org/I200166805"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5009920831"],"corresponding_institution_ids":["https://openalex.org/I200166805"],"apc_list":{"value":560,"currency":"USD","value_usd":560},"apc_paid":{"value":560,"currency":"USD","value_usd":560},"fwci":0.2028,"has_fulltext":true,"cited_by_count":4,"citation_normalized_percentile":{"value":0.38062284,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":87,"max":97},"biblio":{"volume":"7-8","issue":null,"first_page":"100021","last_page":"100021"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11155","display_name":"Toxoplasma gondii Research Studies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},"topics":[{"id":"https://openalex.org/T11155","display_name":"Toxoplasma gondii Research Studies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}},{"id":"https://openalex.org/T10981","display_name":"Cytomegalovirus and herpesvirus research","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11154","display_name":"Parasitic infections in humans and animals","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2405","display_name":"Parasitology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/kidney-transplantation","display_name":"kidney transplantation","score":0.878000020980835},{"id":"https://openalex.org/keywords/epstein-barr-virus-reactivation","display_name":"Epstein-Barr virus reactivation","score":0.9150000214576721},{"id":"https://openalex.org/keywords/post-transplant-lymphoproliferative-disorder","display_name":"post-transplant lymphoproliferative disorder","score":0.9179999828338623},{"id":"https://openalex.org/keywords/sulfadiazine","display_name":"sulfadiazine","score":0.6660000085830688},{"id":"https://openalex.org/keywords/pyrimethamine","display_name":"pyrimethamine","score":0.949999988079071},{"id":"https://openalex.org/keywords/clindamycin","display_name":"clindamycin","score":0.9760000109672546},{"id":"https://openalex.org/keywords/immunosuppression","display_name":"immunosuppression","score":0.7099999785423279},{"id":"https://openalex.org/keywords/chemoprophylaxis","display_name":"chemoprophylaxis","score":0.8690000176429749},{"id":"https://openalex.org/keywords/hemodialysis","display_name":"hemodialysis","score":0.6240000128746033},{"id":"https://openalex.org/keywords/opportunistic-infections","display_name":"opportunistic infections","score":0.5360000133514404}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8111190795898438},{"id":"https://openalex.org/C2780252810","wikidata":"https://www.wikidata.org/wiki/Q1455316","display_name":"Immunosuppression","level":2,"score":0.6788644194602966},{"id":"https://openalex.org/C2778062946","wikidata":"https://www.wikidata.org/wiki/Q154878","display_name":"Toxoplasmosis","level":2,"score":0.6465312242507935},{"id":"https://openalex.org/C2911091166","wikidata":"https://www.wikidata.org/wiki/Q106419912","display_name":"Transplantation","level":2,"score":0.5735652446746826},{"id":"https://openalex.org/C2780303639","wikidata":"https://www.wikidata.org/wiki/Q740909","display_name":"Kidney transplantation","level":3,"score":0.5054912567138672},{"id":"https://openalex.org/C2909675724","wikidata":"https://www.wikidata.org/wiki/Q411648","display_name":"Tacrolimus","level":3,"score":0.4451752305030823},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.42462050914764404},{"id":"https://openalex.org/C2776715498","wikidata":"https://www.wikidata.org/wiki/Q11426176","display_name":"Prednisolone","level":2,"score":0.42278411984443665},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.36464810371398926},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.33747878670692444},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3268253207206726}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1016/j.clinpr.2020.100021","doi":"https://doi.org/10.1016/j.clinpr.2020.100021","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.clinpr.2020.100021","pdf_url":"https://www.sciencedirect.com/science/article/pii/S259017022030008X/pdf","source":{"id":"https://openalex.org/S4210170759","display_name":"Clinical Infection in Practice","issn_l":"2590-1702","issn":["2590-1702"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Infection in Practice","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:5a362acc5ba04d14b4e5260eac5f860f","doi":null,"is_oa":true,"landing_page_url":"https://doaj.org/article/5a362acc5ba04d14b4e5260eac5f860f","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-sa","license_id":"https://openalex.org/licenses/cc-by-sa","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Clinical Infection in Practice, Vol 7, Iss , Pp 100021- (2020)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1016/j.clinpr.2020.100021","doi":"https://doi.org/10.1016/j.clinpr.2020.100021","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.clinpr.2020.100021","pdf_url":"https://www.sciencedirect.com/science/article/pii/S259017022030008X/pdf","source":{"id":"https://openalex.org/S4210170759","display_name":"Clinical Infection in Practice","issn_l":"2590-1702","issn":["2590-1702"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","ki-jl-1","norway-1","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Clinical Infection in Practice","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[{"id":"https://openalex.org/F4320334911","display_name":"St. George's, University of London","ror":"https://ror.org/040f08y74"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W3009166006.pdf","grobid_xml":"https://content.openalex.org/works/W3009166006.grobid-xml"},"referenced_works_count":20,"referenced_works":["https://openalex.org/W1494077646","https://openalex.org/W1526524284","https://openalex.org/W2087416692","https://openalex.org/W2099046884","https://openalex.org/W2099638759","https://openalex.org/W2110893993","https://openalex.org/W2112038800","https://openalex.org/W2118412418","https://openalex.org/W2118661917","https://openalex.org/W2130398739","https://openalex.org/W2160248201","https://openalex.org/W2163460061","https://openalex.org/W2167909719","https://openalex.org/W2467524432","https://openalex.org/W2522086009","https://openalex.org/W2604705569","https://openalex.org/W2810033556","https://openalex.org/W4229743528","https://openalex.org/W4244956837","https://openalex.org/W4251293676"],"related_works":["https://openalex.org/W2157409690","https://openalex.org/W2468151326","https://openalex.org/W4248962461","https://openalex.org/W2106293811","https://openalex.org/W2112038800","https://openalex.org/W2010917542","https://openalex.org/W1494077646","https://openalex.org/W2125795831","https://openalex.org/W2126643825"],"abstract_inverted_index":{"Acute":[0,231],"toxoplasmosis":[1,19,39,155,199,232],"in":[2,236,259],"the":[3,126],"transplant":[4,69,127,191,260,277],"recipient":[5],"can":[6],"be":[7],"a":[8,35,65,75,151,250],"serious":[9],"infection":[10],"and":[11,25,31,82,100,148,156,162,173,184,194,211,244,257,276],"usually":[12],"represents":[13],"reactivation":[14,50,239],"of":[15,37,78,120,143,153,171,252,265],"latent":[16],"infection.":[17,284],"Primary":[18,198],"after":[20,42,200],"transplantation":[21,44,202],"is":[22,26,203,226,249,267],"much":[23],"rarer":[24],"associated":[27,227],"with":[28,45,74,88,160,169,181,205,228],"greater":[29],"morbidity":[30],"mortality.":[32],"We":[33],"report":[34],"case":[36,212],"primary":[38,154],"15":[40,70],"years":[41,71],"kidney":[43,68,190,201],"concomitant":[46,237],"Epstein\u2013Barr":[47],"virus":[48],"(EBV)":[49],"as":[51,53],"well":[52,220],"an":[54],"IRIS-like":[55],"reaction":[56],"to":[57,118,125,140,179,209,241,269,282],"anti-toxoplasma":[58],"treatment.":[59],"A":[60,262],"26-year-old":[61],"man,":[62],"who":[63],"received":[64],"living":[66],"donor":[67],"previously,":[72],"presented":[73,168],"1-week":[76],"history":[77],"fevers,":[79],"headache,":[80],"photophobia":[81],"dry":[83],"cough.":[84],"Immunosuppression":[85],"was":[86,107,123,131,177],"maintained":[87],"prednisolone":[89],"5":[90,102],"mg":[91,97,103],"daily,":[92],"mycophenolate":[93],"mofetil":[94],"(MMF)":[95],"500":[96],"twice":[98,104],"daily":[99],"tacrolimus":[101],"daily.":[105],"He":[106],"treated":[108],"empirically":[109],"for":[110,134],"meningitis,":[111],"although":[112],"initial":[113],"investigations":[114],"were":[115],"unremarkable.":[116],"Due":[117],"worsening":[119,174],"symptoms,":[121],"he":[122,130,157,167,195],"transferred":[124],"centre":[128],"where":[129],"also":[132],"investigated":[133],"suspected":[135],"post-transplant":[136,225],"lymphoproliferative":[137],"disorder":[138],"owing":[139],"rising":[141],"titres":[142],"EBV":[144,238],"DNA.":[145],"Retrospective":[146],"serology":[147],"PCR":[149],"supported":[150],"diagnosis":[152],"started":[158],"treatment":[159],"sulfadiazine":[161],"pyrimethamine.":[163],"After":[164],"72":[165],"h,":[166],"recrudescence":[170],"fever":[172],"lymphadenopathy.":[175],"Sulfadiazine":[176],"switched":[178],"clindamycin":[180],"good":[182],"effect":[183],"his":[185,189],"symptoms":[186],"resolved.":[187],"Unfortunately,":[188],"later":[192],"failed":[193],"re-commenced":[196],"haemodialysis.":[197],"rare,":[204],"existing":[206],"literature":[207],"limited":[208],"case-series":[210],"reports.":[213],"Since":[214],"1966,":[215],"there":[216],"have":[217,234],"been":[218],"20":[219],"described":[221],"cases.":[222],"Early":[223],"presentation":[224],"worse":[229],"outcomes.":[230],"may":[233],"resulted":[235],"due":[240],"impaired":[242],"immunosurveillance":[243],"specific":[245],"cell-mediated":[246],"immunity.":[247],"There":[248],"lack":[251],"consensus":[253],"regarding":[254],"toxoplasma":[255],"screening":[256],"chemoprophylaxis":[258],"recipients.":[261],"high":[263],"index":[264],"suspicion":[266],"required":[268],"ensure":[270],"that":[271],"cases":[272],"are":[273],"not":[274],"missed":[275],"recipients":[278],"should":[279],"receive":[280],"counselling":[281],"prevent":[283]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2021,"cited_by_count":1}],"updated_date":"2026-11-14T11:04:58.165337","created_date":"2020-03-13T00:00:00"}
