CNS toxoplasmosis in an immunocompetent individual

The degree of toxoplasmosis and testicular histomorphometry in rats

Toxoplasma gondii (T. gondii) ranks as the third most common parasitic parasite worldwide, and it is estimated that > 60% of the population is infected with T. gondii worldwide at some point in their lives. So. Therefore, it is highly curious that T. gondii could be a potential cause of idiopathic infertility that is incidental to male partners, who are responsible for nearly 50% of cases. Testicular histomorphometric analysis was developed to investigate fertility problems. The objective of this experimental study was to assess the impact of toxoplasmosis on spermatogenesis indicated by histomorphometric changes in rat testes and its correlation with the degree of infection in the brain. Ninety male Wistar albino rats were infected with T. gondii, and 30 male rats composed the control group. The studied parameters were investigated from the seventh week until the twelfth week postinfection by estimating the body weight, the weight of the testes, histopathological examination, and metric analysis of the testes. Each time, correlations were detected between the investigated parameters and the infection severity calculated by estimating the cyst burden in brain homogenates and brain lesion grading of stained histological sections.Our findings demonstrated a significant adverse impact of toxoplasmosis on absolute body weight, testis weight, and testis histomorphometry. The grading of brain lesions and the number of brain cysts paralleled each other. There was a reverse correlation between the gonado-somatic index and the number of brain cysts and brain lesion grade. There was a statistically significant correlation between the brain cyst count and the brain lesion grade and the indices 20 A, 20b, 250, and 200 of the testes metric analysis. Conclusion: Our results revealed that toxoplasmosis has an adverse impact on male rat spermatogenic cells, which in turn affects spermatogenesis and fertility. This impact is significantly correlated with the degree of latent infection in the brain.

In vitro and in vivo activities of a trithiolato-diRuthenium complex conjugated with sulfadoxine against the apicomplexan parasite Toxoplasma gondii

Organometallic compounds, including Ruthenium complexes, have been widely developed as anti-cancer chemotherapeutics, but have also attracted much interest as potential anti-parasitic drugs. Recently hybrid drugs composed of organometallic Ruthenium moieties that were complexed to different antimicrobial agents were synthesized. One of these compounds, a trithiolato-diRuthenium complex (RU) conjugated to sulfadoxine (SDX), inhibited proliferation of Toxoplasma gondii tachyzoites grown in human foreskin fibroblast (HFF) monolayers with an IC50 < 150 nM, while SDX and the non-modified RU complex applied either individually or as an equimolar mixture were much less potent. In addition, conjugation of SDX to RU lead to decreased HFF cytotoxicity. RU-SDX did not impair the in vitro proliferation of murine splenocytes at concentrations ranging from 0.1 to 0.5 μM but had an impact at 2 μM, and induced zebrafish embryotoxicity at 20 μM, but not at 2 or 0.2 μM. RU-SDX acted parasitostatic but not parasiticidal, and induced transient ultrastructural changes in the mitochondrial matrix of tachyzoites early during treatment. While other compounds that target the mitochondrion such as the uncouplers FCCP and CCCP and another trithiolato-Ruthenium complex conjugated to adenine affected the mitochondrial membrane potential, no such effect was detected for RU-SDX. Evaluation of the in vivo efficacy of RU-SDX in a murine T. gondii oocyst infection model comprised of non-pregnant outbred CD1 mice showed no effects on the cerebral parasite burden, but reduced parasite load in the eyes and in heart tissue.

An atypical case of neurotoxoplasmosis in immunocompetent patient

Toxoplasmosis is an infection caused by Toxoplasma gondii, an intracellular protozoan that is often associated with immunocompromised patients and is rare in immunocompetent. A 60-year-old man was admitted with a history of 2 days of headache and right-sided weakness. There was no history of fever, surgeries, or any other comorbid illness. Cerebrospinal fluid showed just mild pleocytosis with 15 cells/mm³, predominantly lymphomononuclear. MRI showed Peripheral enhancing lesion with central diffusion restriction and perivascular enhancing lesion with restricted diffusion with vasogenic edema and leptomeningeal enhancement in the white matter.

Viral serologies, tumor markers, protein electrophoresis were normal. The patient was submitted to brain biopsy, revealing necrotic brain parenchyma with predominantly acute inflammation, with diffuse encephalitis pattern, and cysts with bradyzoites (cystozoites) of Toxoplasma gondii in the brain parenchyma. The central nervous system infection by Toxoplasma gondii can present as meningoencephalitis during primary infection in an immunocompetent, although it is rare. Central nervous system lymphoma is the main differential diagnosis of neurotoxoplasmosis by imaging, especially in our case.

Toxoplasmosis of the central nervous system: Manifestations vary with immune responses

Toxoplasmosis is an opportunistic infection caused by Toxoplasma gondii (TG), which affects one third of the global human population and commonly involves the central nervous system (CNS)/brain despite the so-called CNS immune privilege. Symptomatic clinical disease of TG infection is much more commonly associated with immunodeficiency; clinicopathological manifestations of CNS toxoplasmosis are linked to individual immune responses including the CNS infiltration of T-cells that are thought to prevent the disease. In patients with autoimmune diseases, immune status is complicated mainly byimmunosuppressant and/or immunomodulatory treatment but typically accompanied by infiltration of T-cells that supposedly fight against toxoplasmosis. In this article, we review characteristics of CNS toxoplasmosis comparatively in immunocompromised patients, immunocompetent patients, and patients with coexisting autoimmune diseases, as well as CNS immune responses to toxoplasmosis with a representative case to demonstrate brain lesions at different stages. In addition to general understanding of CNS toxoplasmosis, our review reveals that clinical manifestations of CNS toxoplasmosis are commonly nonspecific, and incidental pathological findings of TG infection are relatively common in immunocompetent patients and patients with autoimmune diseases (compared to immunocompromised patients); CNS immune responses such as T-cell infiltrates vary in acute and chronic lesions of brain toxoplasmosis.

Acute toxoplasmosis complicated with myopericarditis and possible encephalitis in an immunocompetent patient

We document a case of a 34-year-old man with no medical previous history, presenting with lymphoproliferative syndrome associated to Toxoplasma gondii infection complicated with myopericarditis and possible encephalitis, whose diagnosis was made with lymph node biopsy, cardiac imaging, serology compatible with acute toxoplasmosis and clinical response after treatment.

Fulminant and Diffuse Cerebral Toxoplasmosis as the First Manifestation of HIV Infection: A Case Presentation and Review of the Literature

Patient: Male, 9-year-old

Final Diagnosis: Fulminant and diffuse cerebral toxoplasmosis

Symptoms: Decreased level of consciousness • fever • generalized tonic-clonic seizures • hemiplegia

Medication: —

Clinical Procedure: Decompressive hemicraniectomy

Specialty: Neurosurgery

Toxoplasmosis in an Immunocompetent Patient

Toxoplasmosis is an obligate intracellular, food borne parasite disease with variable clinical presentation. Although the neurological presentation of toxoplasmosis in immunocompetent patients is uncommon, broad differential diagnosis should be kept in consideration when attending to similar patients. Twenty years old man with no known co-morbid conditions presented with fever and unilateral limb weakness for three weeks. It increased gradually, associated with altered level of consciousness for the last five days, diagnosed as acute toxoplasmosis. MRI Brain showed multiple ring enhancing lesions in frontal, parietal and temporal lobes. Serology for toxoplasmosis denoted raised IgM levels 36IU/mL (cut off value > 18IU/mL). This case report describes the clinical presentation and management of neurological toxoplasmosis in immunocompetent patient. Early diagnosis and prompt management can resolve the symptoms at an earlier stage.