{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:07:30Z","timestamp":1789726050449,"version":"4.0.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Toxoplasma gondii infection poses a significant risk for donor seropositive recipient seronegative heart transplant patients without prophylaxis. Guidelines remain unclear on the optimal duration of prophylaxis in this population. We present a case of disseminated toxoplasmosis presenting as a subacute diarrheal illness leading to fulminant infection with pulmonary involvement in a 38-year-old woman 6 months after stopping primary chemoprophylaxis.<\/jats:p>","DOI":"10.1093\/ofid\/ofag491","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:20:50Z","timestamp":1788254450000},"source":"Crossref","is-referenced-by-count":0,"title":["Gastrointestinal Toxoplasmosis in a Heart Transplant Recipient"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3595-2071","authenticated-orcid":false,"given":"Matthew L","family":"Goodwin","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6679-6345","authenticated-orcid":false,"given":"Karen P","family":"Flores Rosario","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aubrie M","family":"Carroll","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avani A","family":"Pendse","sequence":"additional","affiliation":[{"name":"Department of Pathology, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madison","family":"Swaney","sequence":"additional","affiliation":[{"name":"Department of Pathology, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9424-1870","authenticated-orcid":false,"given":"Madeleine R","family":"Heldman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Duke University School of Medicine , Durham, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"2026091805313042600_ofag491-B1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.ijpara.2009.02.004","article-title":"Toxoplasmosis: a history of clinical observations","volume":"39","author":"Weiss","year":"2009","journal-title":"Int J Parasitol"},{"key":"2026091805313042600_ofag491-B2","doi-asserted-by":"crossref","first-page":"27","DOI":"10.7326\/0003-4819-99-1-27","article-title":"Primary and reactivated toxoplasma infection in patients with cardiac transplants. Clinical spectrum and problems in diagnosis in a defined population","volume":"99","author":"Luft","year":"1983","journal-title":"Ann Intern Med"},{"key":"2026091805313042600_ofag491-B3","doi-asserted-by":"crossref","DOI":"10.1111\/tid.13636","article-title":"Clinical characteristics and outcomes of toxoplasmosis among transplant recipients at two US academic medical centers","volume":"23","author":"Adekunle","year":"2021","journal-title":"Transpl Infect Dis"},{"key":"2026091805313042600_ofag491-B4","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.13550","article-title":"Diagnosis and management of diarrhea in solid-organ transplant recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"Angarone","year":"2019","journal-title":"Clin Transplant"},{"key":"2026091805313042600_ofag491-B5","doi-asserted-by":"crossref","first-page":"2613","DOI":"10.1002\/art.38690","article-title":"Development and validation of the HScore, a score for the diagnosis of reactive hemophagocytic syndrome","volume":"66","author":"Fardet","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2026091805313042600_ofag491-B6","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1177\/0885066617711386","article-title":"Interleukin 1 receptor antagonist anakinra, intravenous immunoglobulin, and corticosteroids in the management of critically ill adult patients with hemophagocytic lymphohistiocytosis","volume":"34","author":"Wohlfarth","year":"2019","journal-title":"J Intensive Care Med"},{"key":"2026091805313042600_ofag491-B7","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2020.00524","article-title":"Diagnosis and management of secondary HLH\/MAS following HSCT and CAR-T cell therapy in adults; A review of the literature and a survey of practice within EBMT centres on behalf of the Autoimmune Diseases Working Party (ADWP) and Transplant Complications Working Party (TCWP)","volume":"11","author":"Sandler","year":"2020","journal-title":"Front Immunol"},{"key":"2026091805313042600_ofag491-B8","article-title":"Diarrhea as a presenting symptom of disseminated toxoplasmosis","volume":"2017","author":"Glover","year":"2017","journal-title":"Case Rep Gastrointest Med"},{"key":"2026091805313042600_ofag491-B9","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.ijid.2022.08.023","article-title":"Disseminated toxoplasmosis associated with haemophagocytic lymphohistiocytosis in a patient with the human immunodeficiency virus: a case report and literature review","volume":"123","author":"Washino","year":"2022","journal-title":"Int J Infect Dis"},{"key":"2026091805313042600_ofag491-B10","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1136\/jcp.42.2.194","article-title":"Toxoplasmosis in heart and heart and lung transplant recipients","volume":"42","author":"Wreghitt","year":"1989","journal-title":"J Clin Pathol"},{"key":"2026091805313042600_ofag491-B11","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1086\/368209","article-title":"Trimethoprim-sulfamethoxazole as toxoplasmosis prophylaxis for heart transplant recipients","volume":"36","author":"Mu\u00f1oz","year":"2003","journal-title":"Clin Infect Dis"},{"key":"2026091805313042600_ofag491-B12","doi-asserted-by":"crossref","DOI":"10.1111\/ctr.13546","article-title":"Tissue and blood protozoa including toxoplasmosis, Chagas disease, leishmaniasis, Babesia, Acanthamoeba, Balamuthia, and Naegleria in solid organ transplant recipients\u2014guidelines from the American Society of Transplantation Infectious Diseases Community of Practice","volume":"33","author":"La Hoz","year":"2019","journal-title":"Clin Transplant"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/9\/ofag491\/70891320\/ofag491.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ofid\/article-pdf\/13\/9\/ofag491\/70891320\/ofag491.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:31:45Z","timestamp":1789723905000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofag491\/8778076"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":12,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofag491","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,9,1]]},"article-number":"ofag491"}}