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Case report
peer-reviewed

Toxoplasma Infection in an Immunocompetent Host: Possible Risk of Living with Multiple Cats



Abstract

A 32-year-old man presented with agitation, headache, and confusion. He was immunocompetent and had been living with multiple cats for many years. His vital signs were stable. He was afebrile. Multiple blood tests did not show any serious problem. Brain magnetic resonance imaging (MRI) revealed multiple ring-enhancing white matter lesions. Cerebrospinal fluid analysis did not show any signs of infection. Based on a presumptive diagnosis of multiple sclerosis, high-dose corticosteroid treatment was started. However, this caused worsening of the symptoms and increased the size of the lesions. Corticosteroids were discontinued and biopsy was done. Biopsy of the lesions confirmed Toxoplasma gondii infection, and treatment with pyrimethamine/sulfadiazine was initiated. Treatment decreased the size of the lesions dramatically.

Toxoplasma infection of the central nervous system (CNS) is rare in immunocompetent hosts. Living with multiple cats is believed to be a risk factor for Toxoplasma infection in immunocompetent hosts.



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Case report
peer-reviewed

Toxoplasma Infection in an Immunocompetent Host: Possible Risk of Living with Multiple Cats


Author Information

Halis Kaan Akturk Corresponding Author

Barbara Davis Center for Diabetes, University of Colorado-Anschutz Medical Campus

David Sotello

Department of Infectious Disease, Mayo Clinic

Allen Ameri

Infectious Disease, Creighton University

Ahmed S. Abuzaid

Cardiology, Christiana Care Health System

Ana Marcella Rivas

Endocrinology, Mayo Clinic

Priyanka Vashisht

Department of Rheumatology, University of Nebraska


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.


Case report
peer-reviewed

Toxoplasma Infection in an Immunocompetent Host: Possible Risk of Living with Multiple Cats


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Case report
peer-reviewed

Toxoplasma Infection in an Immunocompetent Host: Possible Risk of Living with Multiple Cats

  • Author Information
    Halis Kaan Akturk Corresponding Author

    Barbara Davis Center for Diabetes, University of Colorado-Anschutz Medical Campus

    David Sotello

    Department of Infectious Disease, Mayo Clinic

    Allen Ameri

    Infectious Disease, Creighton University

    Ahmed S. Abuzaid

    Cardiology, Christiana Care Health System

    Ana Marcella Rivas

    Endocrinology, Mayo Clinic

    Priyanka Vashisht

    Department of Rheumatology, University of Nebraska


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Informed consent obtained. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements


    Article Information

    Published: March 19, 2017

    DOI

    10.7759/cureus.1103

    Cite this article as:

    Akturk H, Sotello D, Ameri A, et al. (March 19, 2017) Toxoplasma Infection in an Immunocompetent Host: Possible Risk of Living with Multiple Cats. Cureus 9(3): e1103. doi:10.7759/cureus.1103

    Publication history

    Received by Cureus: December 24, 2016
    Peer review began: January 04, 2017
    Peer review concluded: March 14, 2017
    Published: March 19, 2017

    Copyright

    © Copyright 2017
    Akturk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

A 32-year-old man presented with agitation, headache, and confusion. He was immunocompetent and had been living with multiple cats for many years. His vital signs were stable. He was afebrile. Multiple blood tests did not show any serious problem. Brain magnetic resonance imaging (MRI) revealed multiple ring-enhancing white matter lesions. Cerebrospinal fluid analysis did not show any signs of infection. Based on a presumptive diagnosis of multiple sclerosis, high-dose corticosteroid treatment was started. However, this caused worsening of the symptoms and increased the size of the lesions. Corticosteroids were discontinued and biopsy was done. Biopsy of the lesions confirmed Toxoplasma gondii infection, and treatment with pyrimethamine/sulfadiazine was initiated. Treatment decreased the size of the lesions dramatically.

Toxoplasma infection of the central nervous system (CNS) is rare in immunocompetent hosts. Living with multiple cats is believed to be a risk factor for Toxoplasma infection in immunocompetent hosts.



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Create a free account to continue reading this article.

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Halis Kaan Akturk

Barbara Davis Center for Diabetes, University of Colorado-Anschutz Medical Campus

For correspondence:
kaanakturk@yahoo.com

David Sotello

Department of Infectious Disease, Mayo Clinic

Allen Ameri

Infectious Disease, Creighton University

Ahmed S. Abuzaid

Cardiology, Christiana Care Health System

Ana Marcella Rivas

Endocrinology, Mayo Clinic

Priyanka Vashisht

Department of Rheumatology, University of Nebraska

Halis Kaan Akturk

Barbara Davis Center for Diabetes, University of Colorado-Anschutz Medical Campus

For correspondence:
kaanakturk@yahoo.com

David Sotello

Department of Infectious Disease, Mayo Clinic

Allen Ameri

Infectious Disease, Creighton University

Ahmed S. Abuzaid

Cardiology, Christiana Care Health System

Ana Marcella Rivas

Endocrinology, Mayo Clinic

Priyanka Vashisht

Department of Rheumatology, University of Nebraska