International Journal of Molecular and Cellular Medicine

en Pulmonary toxoplasmosis in a multiple myeloma patient: A Case report and literature review Infectious disease (Molecular and Cellular aspects) Infectious disease (Molecular and Cellular aspects) Case Report Case Report Pulmonary toxoplasmosis is a rare but potentially fatal opportunistic infection, most often reported in HIV-infected individuals. Its occurrence in non-HIV immunocompromised patients—particularly those with hematologic malignancies like multiple myeloma (MM)—is exceedingly rare and diagnostically challenging due to nonspecific clinical and radiologic features. While Toxoplasma gondii infection is typically mild in immunocompetent hosts, it can cause severe disease in immunocompromised populations. A literature review was conducted using PubMed, Scopus, and Google Scholar (January 2000–May 2025) with keywords: ‘pulmonary toxoplasmosis,’ ‘multiple myeloma,’ ‘non-HIV,’ ‘immunocompromised,’ and ‘BAL PCR.’ Only English-language case reports and reviews were included, with emphasis on studies from endemic regions and the past five years. We report a 49-year-old Iranian man with newly diagnosed IgG kappa MM who presented with fever, chills, vomiting, and dyspnea. Chest CT revealed a 4.2 × 3.8 cm consolidation in the posterior segment of the right lower lobe. T. gondii infection was confirmed via bronchoalveolar lavage (BAL) through tachyzoite detection on Giemsa stain and molecular identification using qPCR and nested PCR targeting the Gra6 gene. He showed transient clinical improvement and was discharged on hospital day 7. Unfortunately, he died at home within 48 hours due to MM progression, before anti-toxoplasmosis therapy was initiated. This case underscores the diagnostic difficulty of pulmonary toxoplasmosis in non-HIV immunocompromised patients and the importance of molecular BAL testing. Prophylactic measures such as co-trimoxazole should be considered in high-risk MM patients. Guidelines must address screening and management in this vulnerable population.   Bronchoalveolar lavage, Co-trimoxazole, Immunocompromised host, Lung, Multiple myeloma, Pulmonary toxoplasmosis, Toxoplasma gondii 1129 1137 http://ijmcmed.org/browse.php?a_code=A-10-8463-1&slc_lang=en&sid=1 Asgar Baghernejad Nesheli asgharbaghernezhad.nesheli@gmail.com 100319475328460036833 0009-0009-5457-5305 No Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran. Somayeh Sadeghi s.sadeghi117917@gmai.com 100319475328460036834 100319475328460036834 No Department of Internal Medicine, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran. Mahdi Fakhar mahdi.fakhar53@gmail.com 100319475328460036835 100319475328460036835 No Department of Medical Microbiology and Immunology, School of Medicine, Qom University of Medical Sciences, Qom, Iran Sara Ghandi sara.ghandi2003@gmail.com 100319475328460036836 0009-0008-7920-6031 No Toxoplasmosis Research Center, Communicable Diseases Institute, Department of Parasitology, Mazandaran University of Medical Sciences, Sari, Iran. Sadegh Fattahi fattahi_pgs@yahoo.com 100319475328460036837 100319475328460036837 No North Research Center, Pasteur Institute of Iran, Amol, Iran. Eissa Soleymani E.Soleymani@mazums.ac.ir 100319475328460036838 100319475328460036838 No Iranian National Registry Center for Lophomoniasis and Toxoplasmosis, Imam Khomeini Hospital, Mazandaran University of Medical Sciences, Sari, Iran. Abbasali Eskandarian aeskandarian@med.mui.ac.ir 100319475328460036839 100319475328460036839 Yes Department of Medical Parasitology and Mycology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.