Acquired Toxoplasmosis

Abstract

The neurological manifestations of six cases of acquired central nervous system toxoplasmosis are compared with the 39 well-documented cases from the literature. Half of the patients had underlying systemic diseases (18 malignant neoplasms, two renal transplants, three collagen vascular diseases) treated with intensive immunosuppressive therapy. The remainder had primary toxoplasmosis. Three major neurological patterns were seen: (1) diffuse encephalopathy with or without seizures, (2) meningoencephalitis, and (3) singular or multiple progressive mass lesions. Routine neurological diagnostic studies were not helpful. The Sabin-Feldman dye test or IgM indirect fluorescent antibody test or both were effective in confirming the diagnosis. Twenty-seven patients died without a clinical diagnosis of toxoplasmosis. The diagnosis was made terminally in four additional patients. Thirteen of fourteen patients who received a full course of sulfadiazine or pyrimethamine or both did well. Toxoplasmosis should be considered in the immunosuppressed patient who appears with neurological involvement.

Anatomopathological study in BALB/c mice brains experimentally infected with Toxoplasma gondii

“…The microscopic lesions found were consistent to the ones reported by other authors which studied lesions in humans [7,9,11]. This study confirms the importance of T. gondii as a cause of active and severe lesion in the central nervous system.…”

“…Amongst the symptomatic forms, the neurological involvement is the most common, observed as encephalitis or meningoencephalitis with unspecific symptoms [3]. The beginning may be marked by cephalalgia, somnolence and behavioral changes, during from days to weeks, followed by coma, convulsions, pyramidal or cerebellar syndrome, ophthalmologic paralysis and psychic alterations [3][4][5][6][7][8]. The encephalitis usually is diffuse and focal lesions leading to localized manifestations are rarely observed [5,7].…”

Central Nervous System Toxoplasmosis in Relapsed Hodgkin’s Lymphoma: A Case Report

“…Diffuse toxoplasmosis with CNS involvement is a life-threatening disease which often avoids diagnosis (1, 8). In a review of 45 patients with CNS-toxoplasmosis, less than 40% were diagnosed prior to death.…”

“…In a review of 45 patients with CNS-toxoplasmosis, less than 40% were diagnosed prior to death. However, early diagnosis of the disease has been rewarded by a rapid response to treatment (8). …”

Macrophage responses to Toxoplasma antigens in vitro: a possible role in inflammatory lesions in toxoplasmosis.

“…3,[28][29][30] Studies have shown that in recrudescent toxoplasmosis, Toxoplasma tachyzoites or antigens were associated with microglial nodules that were not found in the adjacent parenchyma. 31,32 The presence of mononuclear cells and the availability of antigens provide a favorable condition for activation of macrophages to synthesize and release enzymes.…”