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免疫功能正常者的神经型弓形虫病:一种罕见情况。

Neurotoxoplasmosis in the Immunocompetent: A Rare Occurrence.

作者信息

Khalid Saad, Memon Shehzeen F, Jumani Laraib, Memon Shahzeb A, Siddiqui Mishal S

机构信息

Department of Medicine, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.

Department of Neurology, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK.

出版信息

Cureus. 2023 Mar 28;15(3):e36782. doi: 10.7759/cureus.36782. eCollection 2023 Mar.

DOI:10.7759/cureus.36782
PMID:37123766
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10134001/
Abstract

Cerebral toxoplasmosis is a rare condition that predominantly affects immunocompromised people and is relatively uncommon in immunocompetent individuals. Acute toxoplasmosis primarily presents with focal and diffuse neurological signs and symptoms depending on the site of the lesion, the degree of local damage, and the severity of inflammation. In this report, we present a case of cerebral toxoplasmosis in an immunocompetent adult female who presented with an altered level of consciousness, fever, headache, and shortness of breath. This case highlights the diagnostic challenges that may arise when dealing with patients who have a wide range of clinical manifestations.

摘要

脑弓形虫病是一种罕见疾病,主要影响免疫功能低下者,在免疫功能正常个体中相对不常见。急性弓形虫病主要根据病变部位、局部损伤程度和炎症严重程度,表现为局灶性和弥漫性神经体征及症状。在本报告中,我们介绍了一例免疫功能正常的成年女性脑弓形虫病病例,该患者出现意识水平改变、发热、头痛和呼吸急促。该病例突出了在处理具有广泛临床表现的患者时可能出现的诊断挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce25/10134001/6a2fb37b6887/cureus-0015-00000036782-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce25/10134001/6a2fb37b6887/cureus-0015-00000036782-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce25/10134001/6a2fb37b6887/cureus-0015-00000036782-i01.jpg

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Imaging in Differentiating Cerebral Toxoplasmosis and Primary CNS Lymphoma With Special Focus on FDG PET/CT.脑弓形虫病与原发性中枢神经系统淋巴瘤的影像鉴别,重点关注 FDG PET/CT。
AJR Am J Roentgenol. 2021 Jan;216(1):157-164. doi: 10.2214/AJR.19.22629. Epub 2020 Oct 28.
2
Cerebral toxoplasmosis associated with treatment with rituximab, azathioprine and prednisone for dermatomyositis.脑弓形虫病与治疗皮肌炎用利妥昔单抗、硫唑嘌呤和泼尼松相关。
Br J Clin Pharmacol. 2021 Mar;87(3):1525-1528. doi: 10.1111/bcp.14445. Epub 2020 Aug 3.
3
HIV-Related Cerebral Toxoplasmosis Revisited: Current Concepts and Controversies of an Old Disease.
再探与HIV相关的脑弓形虫病:一种古老疾病的当前概念与争议
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958219867315. doi: 10.1177/2325958219867315.
4
Congenital toxoplasmosis: An overview of the neurological and ocular manifestations.先天性弓形虫病:神经和眼部表现概述
Parasitol Int. 2018 Dec;67(6):715-721. doi: 10.1016/j.parint.2018.07.004. Epub 2018 Jul 21.
5
Cerebral toxoplasmosis diagnosed by brain tissue PCR analysis in an immunocompetent patient.一名免疫功能正常的患者经脑组织聚合酶链反应(PCR)分析确诊为脑弓形虫病。
Neurol Clin Pract. 2017 Oct;7(5):436-438. doi: 10.1212/CPJ.0000000000000364.
6
Intra-cranial Toxoplasmosis in an Immunocompetent Female.一名免疫功能正常女性的颅内弓形虫病
J Coll Physicians Surg Pak. 2016 Jun;26(6 Suppl):S39-41.
7
Tomographic findings of acute pulmonary toxoplasmosis in immunocompetent patients.免疫功能正常患者急性肺弓形虫病的断层扫描表现。
BMC Pulm Med. 2014 Nov 25;14:185. doi: 10.1186/1471-2466-14-185.
8
Toxoplasmosis.弓形虫病
Handb Clin Neurol. 2013;114:125-45. doi: 10.1016/B978-0-444-53490-3.00008-X.
9
Epidemiology of and diagnostic strategies for toxoplasmosis.弓形虫病的流行病学和诊断策略。
Clin Microbiol Rev. 2012 Apr;25(2):264-96. doi: 10.1128/CMR.05013-11.
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Toxoplasma gondii infection and cerebral toxoplasmosis in HIV-infected patients.弓形虫感染和 HIV 感染患者的脑弓形虫病。
Future Microbiol. 2009 Dec;4(10):1363-79. doi: 10.2217/fmb.09.89.