Anna Beltrame1,2, Sergio Venturini3, Giovanni Crichiutti4, Valeria Meroni5, Dora Buonfrate6, Matteo Bassetti3. 1. Centre for Tropical Diseases, Sacro Cuore Hospital, via Sempreboni 5, 37024, Negrar, Italy. anna.beltrame@sacrocuore.it. 2. Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy. anna.beltrame@sacrocuore.it. 3. Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy. 4. Department of Paediatrics, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy. 5. Department of Internal Medicine and Therapeutics, Microbiology and Virology Department Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy. 6. Centre for Tropical Diseases, Sacro Cuore Hospital, via Sempreboni 5, 37024, Negrar, Italy.
Abstract
INTRODUCTION: We report an unusual case of acute acquired toxoplasmosis (AAT) presenting as lymphadenopathy and recurrent seizures in an immunocompetent 15-year-old boy. MATERIALS AND METHODS: The patient reported an 18-day vacation to Africa (Ethiopia), 39 days prior to the first seizure. Electroencephalogram (EEG) showed sporadic single-spike or sharp-wave paroxysms and the magnetic resonance imaging (RMI) of the brain was negative. The serology for T. gondii was compatible with an acute infection defined as positive for both toxoplasma-specific IgG and IgM and a low avidity (6 %), confirmed by a reference laboratory. The patient reported other two episodes of seizures, occurring 7 days apart. He was treated with pyrimethamine plus sulfadiazine and leucovorin for 4 weeks, with an improvement of lymphadenitis and normalization of EEG. After 5 months, new seizures were reported and a diagnosis of epilepsy was done. Toxoplasma polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) and blood were negative. A treatment with valproic acid was started, obtaining control of the neurological disease. CONCLUSION: Awareness of this neurologic manifestation by clinicians is required, also in immunocompetent patients. The relationship between toxoplasmosis and recurrent seizure needs to be investigated by new studies.
INTRODUCTION: We report an unusual case of acute acquired toxoplasmosis (AAT) presenting as lymphadenopathy and recurrent seizures in an immunocompetent 15-year-old boy. MATERIALS AND METHODS: The patient reported an 18-day vacation to Africa (Ethiopia), 39 days prior to the first seizure. Electroencephalogram (EEG) showed sporadic single-spike or sharp-wave paroxysms and the magnetic resonance imaging (RMI) of the brain was negative. The serology for T. gondii was compatible with an acute infection defined as positive for both toxoplasma-specific IgG and IgM and a low avidity (6 %), confirmed by a reference laboratory. The patient reported other two episodes of seizures, occurring 7 days apart. He was treated with pyrimethamine plus sulfadiazine and leucovorin for 4 weeks, with an improvement of lymphadenitis and normalization of EEG. After 5 months, new seizures were reported and a diagnosis of epilepsy was done. Toxoplasma polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) and blood were negative. A treatment with valproic acid was started, obtaining control of the neurological disease. CONCLUSION: Awareness of this neurologic manifestation by clinicians is required, also in immunocompetent patients. The relationship between toxoplasmosis and recurrent seizure needs to be investigated by new studies.
Authors: M Demar; D Hommel; F Djossou; C Peneau; R Boukhari; D Louvel; A-M Bourbigot; V Nasser; D Ajzenberg; M-L Darde; B Carme Journal: Clin Microbiol Infect Date: 2011-09-29 Impact factor: 8.067
Authors: Elizabeth de Souza Neves; Andrea Kropf; Wendy Fernandes Bueno; Isabel Cristina Fabregas Bonna; André Luis Land Curi; Maria Regina R Amendoeira; Octavio Fernandes Filho Journal: Trop Doct Date: 2010-11-09 Impact factor: 0.731
Authors: Giuseppe Pustorino; Edoardo Ferlazzo; Maria Stella Carpentieri; Vittoria Cianci; Sara Gasparini; Mauro Campello; Giovanni Luigi Milardi; Antonio Gangemi; Umberto Aguglia Journal: Neurol Clin Pract Date: 2017-10