Abstract
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.

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