Infection or Malignancy? A Novel Co-Diagnosis in a Patient After Hematopoietic Stem Cell Transplant

Patients undergoing hematopoietic stem cell transplant are susceptible to various opportunistic infections after transplantation, including reactivation of latent infections. We report a patient with acute neurologic worsening after allogeneic hematopoietic stem cell transplant complicated by chronic graft-versus-host disease who was concurrently diagnosed with cerebral toxoplasmosis and post-transplant lymphoproliferative disorder with central nervous system involvement, the first such reported co-diagnosis to our knowledge. Management of these patients can be challenging due to the continued need for immunosuppression to control graft-versus-host disease. Due to the high mortality associated with either condition, this co-diagnosis ultimately proved fatal in our patient.