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免疫功能正常患者的弓形虫病

Toxoplasmosis in an Immunocompetent Patient.

作者信息

Basit Khalid Abdul, Nasir Sadaf, Vohra Ejaz, Shazlee Muhammad Kashif

机构信息

Khalid Abdul Basit, MBBS. Resident Medical Officer, Dr. Ziauddin Hospital, Karachi, Pakistan.

Sadaf Nasir MCPS (Internal Medicine). Registrar, Medicine Department, Dr. Ziauddin Hospital, Karachi, Pakistan.

出版信息

Pak J Med Sci. 2018 Nov-Dec;34(6):1579-1581. doi: 10.12669/pjms.346.15016.

Abstract

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.

摘要

弓形虫病是一种专性细胞内、食源性寄生虫病,临床表现多样。虽然免疫功能正常患者的弓形虫病神经学表现并不常见,但在诊治类似患者时应考虑进行广泛的鉴别诊断。一名20岁、无已知合并症的男性患者出现发热和单侧肢体无力三周。症状逐渐加重,在过去五天伴有意识水平改变,被诊断为急性弓形虫病。脑部MRI显示额叶、顶叶和颞叶有多个环形强化病灶。弓形虫病血清学检查显示IgM水平升高至36IU/mL(临界值>18IU/mL)。本病例报告描述了免疫功能正常患者神经型弓形虫病的临床表现及治疗。早期诊断和及时治疗可在更早阶段缓解症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0351/6290221/75d08ac1d998/PJMS-34-1579-g001.jpg

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