Spinal cord toxoplasmosis in a young immunocompetent patient
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CASE REPORT
Spinal cord toxoplasmosis in a young immunocompetent patient M. Martinot1 · V. Greigert1,2 · C. Farnarier3 · M. L. Dardé4,5 · C. Piperoglou3 · M. Mohseni‑Zadeh1 · J. Tarabeux6 · A. Guffroy7,8 · O. Villard2 · F. Vely3,9 Received: 20 September 2019 / Accepted: 3 December 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract We report a case of spinal cord toxoplasmosis occurring as a primary infection in a 31-year-old immunocompetent man. Exhaustive immunologic and genetic investigations did not identify any immunodeficiency. The causative agent was a typical type 2 strain. In cases of spinal cord lesions, toxoplasmosis should be considered, even in an immunocompetent patient. Keywords Toxoplasmosis · Primary infection · Immunocompetent patient · Spinal cord · Toxoplasma gondii
Introduction Toxoplasmosis is one of the most frequent human protozoan infections. About one-third of the world’s population is affected by latent toxoplasmosis. It is often asymptomatic or may cause mild flu-like symptoms, including fever, myalgia, and lymphadenopathy. However, in immunodeficient patients, the infection can lead to severe disease, notably with neurologic involvement. Spinal cord toxoplasmosis, though, is extremely rare, with less than 30 cases reported. These infections have occurred exclusively in immunodeficient patients, mainly in those with acquired immune deficiency syndrome (AIDS) or other severe immunodeficiency disorders [1–5]. Outbreaks of complicated toxoplasmosis
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s15010-019-01380-9) contains supplementary material, which is available to authorized users. * M. Martinot martin.martinot@ch‑colmar.fr 1
Infectious and Tropical Diseases Department, Medecine E Hôpitaux Civils de Colmar, 39 Avenue de la liberté, 68024 Colmar, France
2
Parasitology Department, Strasbourg University, Strasbourg, France
3
APHM, Hôpital de la Timone, Service d’Immunologie, Marseille‑Immunopole, Marseille, France
4
Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France
have been described among immunocompetent patients, caused by infection with atypical virulent strains, particularly in French Guiana [6]. We report the first case of acute spinal cord toxoplasmosis in an immunocompetent individual infected with a typical type 2 Toxoplasma gondii strain.
Case report A 31-year-old man with no remarkable medical history was hospitalized in the Department of Neurosurgery, Colmar Hospital, with the acute onset of the Brown–Séquard syndrome, characterized by left arm paresis and hypesthesia of the right leg and right torso. The patient reported that he had had fever and chills 2 weeks before admission. He worked as a veterinarian and went hunting regularly, providing wild boar meat for his own consumption. He had no history of travel outside Europe for 6 months preceding admission. A 5
INSERM, Univ
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