Pfohl Jessica C, Dewey Curtis W
Dallas Veterinary Surgical Center, 4444 Trinity Mills Road, Suite 203, Dallas, TX 75287, USA.
J Feline Med Surg. 2005 Dec;7(6):369-74. doi: 10.1016/j.jfms.2005.03.004.
An 8-year-old cat with recent-onset generalized seizures was diagnosed with a right forebrain mass using magnetic resonance imaging. The mass was excised and upon histologic and immunohistochemical examination shown to be a Toxoplasma gondii granuloma. Serology supported active T gondii infection. The cat was treated with phenobarbital to control seizures. After definitive diagnosis of toxoplasma granuloma, clindamycin was administered for approximately 1 month. Seizures recurred 8 months after initial presentation, and the cat was euthanased at the owner's request. This is a previously unreported manifestation of feline central nervous system toxoplasmosis. When a mass lesion is present in the brain of a cat and serologic test results support active infection with T gondii, toxoplasma granuloma must be a differential diagnosis. If the patient is suffering from clinical disease, surgical resection of the mass (if possible) can be complimented with medical treatment until definitive diagnosis is obtained. Immunocompromising factors should be identified and addressed if possible.
一只8岁的猫近期出现全身性癫痫发作,经磁共振成像诊断为右前脑肿块。该肿块被切除,经组织学和免疫组织化学检查显示为弓形虫肉芽肿。血清学检查支持弓形虫的活动性感染。这只猫接受了苯巴比妥治疗以控制癫痫发作。在明确诊断为弓形虫肉芽肿后,给予克林霉素治疗约1个月。初次就诊8个月后癫痫复发,应主人要求对该猫实施了安乐死。这是猫中枢神经系统弓形虫病一种先前未报道过的表现形式。当猫脑内出现占位性病变且血清学检测结果支持弓形虫的活动性感染时,弓形虫肉芽肿必须作为鉴别诊断之一。如果患者患有临床疾病,在获得明确诊断之前,对肿块进行手术切除(如果可能的话)可辅以药物治疗。应尽可能识别并处理免疫抑制因素。