Spinal Cord Lesions in Congenital Toxoplasmosis Demonstrated with Neuroimaging, Including Their Successful Treatment in an Adult

Abstract

Neuroimaging studies for persons in the National Collaborative Chicago-Based Congenital Toxoplasmosis Study (NCCCTS) with symptoms and signs referable to the spinal cord were reviewed. Three infants had symptomatic spinal cord lesions, another infant a Chiari malformation, and another infant a symptomatic peri-spinal cord lipoma. One patient had an unusual history of prolonged spinal cord symptoms presenting in middle age. Neuroimaging was used to establish her diagnosis and response to treatment. This 43 year-old woman with congenital toxoplasmosis developed progressive leg spasticity, weakness, numbness, difficulty walking, and decreased visual acuity and color vision without documented re-activation of her chorioretinal disease. At 52 years of age, spinal cord lesions in locations correlating with her symptoms and optic atrophy were diagnosed with 3 Tesla MRI scan. Treatment with pyrimethamine and sulfadiazine decreased her neurologic symptoms, improved her neurologic examination, and resolved her enhancing spinal cord lesions seen on MRI.

Parasite Specific Antibody Increase Induced by an Episode of Acute P. falciparum Uncomplicated Malaria

“…While only few (n = 68) people living with human immunodeficiency virus infection/ acquired immuno-deficiency syndrome (HIV/AIDS) (PLWHAs) were enrolled in this study, up to 10% of residents in malaria endemic areas comprise PLWHAs and co infection of P . falciparum and malaria is important [ 50 , 51 ]. The duration of how long they were infected is not known.…”

Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances “Take a Village”

“…The earlier papers in this series presented studies by students and colleagues focused on educational tools and their efficacy in Panamá’, Colombia and the United States and on epidemiological aspects of Toxoplasma infection and toxoplasmosis in the USA, Europe, Morocco, Brazil, Panamá’ and Colombia. It is clear from earlier studies in the United States [ 1 ••, 2 , 3 ••, 4 ••, 5 ••, 6 ••, 7 ••, 8 ••, 9 ••, 10 ••, 11 ••, 12 , 13 , 14 ••, 15 ••, 16 ••, 17 ••, 18 •, 19 •, 20 •, 21 •, 22 •, 23 , 24 ••, 25 , 26 , 27 •, 28 •, 29 – 30 , 31 •, 32 •, 33 ••, 34 •, 35 •, 36 , 37 •, 38 •, 39 ••, 40 •, 41 •, 42 ••, 43 ••, 44 ••, 45 , 46 •, 47 ••, 48 ••, 49 , 50 •], and the present studies that access to inexpensive, effective diagnostic tools and anti-parasitic treatment( and ultimately vaccines) [ 1 ••, 2 , 3 ••, 4 ••, 5 ••, 6 ••, 7 ••, 8 ••, 9 ••, 10 ••, 11 ••, 12 , 13 , 14 ••, 15 ••, …”

“…These are reviewed and summarized in order to emphasize the importance of, and steps to build, programs to address the clinical and public health challenges of preventing congenital toxoplasmosis. This analysis and discussion places work in the United States [ 1 ••, 2 , 3 ••, 4 ••, 5 ••, 6 ••, 7 ••, 8 ••, 9 ••, 10 ••, 11 ••, 12 , 13 , 14 ••, 15 ••, 16 ••, 17 ••, 18 •, 19 •, 20 •, 21 •, 22 •, 23 , 24 ••, 25 , 26 , 27 •, 28 •, 29 – 30 , 31 •, 32 •, 33 ••, 34 •, 35 •, 36 , 37 •, 38 •, 39 ••, 40 •, 41 •, 42 ••, 43 ••, 44 ••, 45 , 46 •, 47 ••, 48 ••, 49 , 50 , 52 , 55 ••, 56 ••], Panama [ 59 •] and Colombia [ 63 , 65 , 97 ], in the context of progress in other countries [ 51 •, 52 , 53 ••, 54 , 55 ••, 56 ••, 57 •, 58 ••, 59 •, 60 ••, 61 , …”

“…Part IV considers briefly the foundation to which these studies contribute, providing a rationale and framework for extending the studies. This includes additional basic science and translational work and needed improvements in clinical care [ 1 ••, 2 , 3 ••, 4 ••, 5 ••, 6 ••, 7 ••, 8 ••, 9 ••, 10 ••, 11 ••, 12 , 13 , 14 ••, 15 ••, 16 ••, 17 ••, 18 •, 19 •, 20 •, 21 •, 22 •, 23 , 24 ••, 25 , 26 , 27 •, 28 •, 29 – 30 , 31 •, 32 •, 33 ••, 34 •, 35 •, 36 , 37 •, 38 •, 39 ••, 40 •, 41 •, 42 ••, 43 ••, 44 ••, 45 , 46 •, 47 ••, 48 ••, 49 , 50 •, 51 •, 52 , 53 ••, 54 , 55 ••, 56 ••, 57 •, 58 ••, 64.•• ••, 68 ••, 88 ••, 89 ••, 90 , 91 , 92 ••, 93 , 94 , 118 ••, 124 , 125 …”

Cervical Spinal Cord Toxoplasmosis in a Patient with AIDS: Case Report and Review of the Literature

“…A pregnant woman may acquire this parasite during gestation. Toxoplasma gondii can be found in up to 50% of the world population [3]. Approximately 10% of patients with Acquired Immune Deficiency Syndrome (AIDS) show some kind of neurological deficit as their primary complaint, and around 80% will have Central Nervous System (CNS) involvement during the course of their illness [1,4,5].…”