Wong Weng Kit, Upton Arlo, Thomas Mark G
Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
Scand J Infect Dis. 2013 May;45(5):357-61. doi: 10.3109/00365548.2012.737017. Epub 2012 Dec 4.
Chronic toxoplasmosis has been shown to be strongly associated with a range of neuropsychiatric effects including schizophrenia and suicide. However there have not been any prospective, community-based studies of the neuropsychiatric effects of acute toxoplasmosis in adult immunocompetent patients.
Adult patients with a positive serum IgM anti-Toxoplasma gondii test result, in the context of an acute illness with lymphadenopathy, were invited to complete a questionnaire seeking information relating to the nature, severity, and duration of symptoms in the months following the diagnosis of acute toxoplasmosis.
Laboratory testing identified a total of 187 adults who had a positive serum IgM anti-T. gondii test result between 1 January and 30 November 2011. Consent to contact 108/187 (58%) patients was provided by their family doctor; 37 (34%) of these 108 patients completed and returned the questionnaire. Questionnaires from the 31/108 (29%) patients who reported swollen lymph nodes during their illness were included in the study. Fatigue (90%), headache (74%), difficulty concentrating (52%), and muscle aches (52%) were the most commonly reported symptoms. These symptoms commonly persisted for at least 4 weeks. Twenty-seven of 31 (87%) subjects reported a moderate or severe reduction in their overall physical and mental health during the first 2 months of illness.
Acute toxoplasmosis in immunocompetent adults commonly causes moderately severe neuropsychiatric symptoms that might result from replication of the organism in the central nervous system with consequent effects on brain function. Patients should be advised that such symptoms are common and reassured that they usually resolve completely within a few months.
慢性弓形虫病已被证明与一系列神经精神效应密切相关，包括精神分裂症和自杀。然而，尚未有针对免疫功能正常的成年患者急性弓形虫病神经精神效应的前瞻性社区研究。
邀请血清抗弓形虫IgM检测结果呈阳性、患有急性疾病并伴有淋巴结病的成年患者填写一份问卷，以获取急性弓形虫病诊断后数月内症状的性质、严重程度和持续时间等信息。
实验室检测共确定了187名在2011年1月1日至11月30日期间血清抗弓形虫IgM检测结果呈阳性的成年人。他们的家庭医生同意联系其中108/187（58%）名患者；这108名患者中有37名（34%）完成并返回了问卷。研究纳入了31/108（29%）名在患病期间报告有淋巴结肿大的患者的问卷。疲劳（90%）、头痛（74%）、注意力不集中（52%）和肌肉疼痛（52%）是最常报告的症状。这些症状通常持续至少4周。31名受试者中有27名（87%）报告在患病的前两个月内其整体身心健康有中度或重度下降。
免疫功能正常的成年人急性弓形虫病通常会导致中度严重的神经精神症状，这可能是由于病原体在中枢神经系统中复制，进而影响脑功能所致。应告知患者此类症状很常见，并让他们放心，这些症状通常在几个月内会完全缓解。
