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Recurrent seizures during acute acquired toxoplasmosis in an immunocompetent traveller returning from Africa

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Abstract

Introduction

We report an unusual case of acute acquired toxoplasmosis (AAT) presenting as lymphadenopathy and recurrent seizures in an immunocompetent 15-year-old boy.

Materials and methods

The patient reported an 18-day vacation to Africa (Ethiopia), 39 days prior to the first seizure. Electroencephalogram (EEG) showed sporadic single-spike or sharp-wave paroxysms and the magnetic resonance imaging (RMI) of the brain was negative. The serology for T. gondii was compatible with an acute infection defined as positive for both toxoplasma-specific IgG and IgM and a low avidity (6 %), confirmed by a reference laboratory. The patient reported other two episodes of seizures, occurring 7 days apart. He was treated with pyrimethamine plus sulfadiazine and leucovorin for 4 weeks, with an improvement of lymphadenitis and normalization of EEG. After 5 months, new seizures were reported and a diagnosis of epilepsy was done. Toxoplasma polymerase chain reaction (PCR) of cerebrospinal fluid (CSF) and blood were negative. A treatment with valproic acid was started, obtaining control of the neurological disease.

Conclusion

Awareness of this neurologic manifestation by clinicians is required, also in immunocompetent patients. The relationship between toxoplasmosis and recurrent seizure needs to be investigated by new studies.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Centre for Tropical Diseases, Sacro Cuore Hospital, via Sempreboni 5, 37024, Negrar, Italy

    Anna Beltrame & Dora Buonfrate

  2. Clinic of Infectious Diseases, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy

    Anna Beltrame, Sergio Venturini & Matteo Bassetti

  3. Department of Paediatrics, Azienda Ospedaliero-Universitaria di Udine, Udine, Italy

    Giovanni Crichiutti

  4. Department of Internal Medicine and Therapeutics, Microbiology and Virology Department Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy

    Valeria Meroni

Authors
  1. Anna Beltrame
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  2. Sergio Venturini
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  3. Giovanni Crichiutti
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  4. Valeria Meroni
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  5. Dora Buonfrate
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  6. Matteo Bassetti
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Corresponding author

Correspondence to Anna Beltrame.

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Beltrame, A., Venturini, S., Crichiutti, G. et al. Recurrent seizures during acute acquired toxoplasmosis in an immunocompetent traveller returning from Africa. Infection 44, 259–262 (2016). https://doi.org/10.1007/s15010-015-0821-7

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  • DOI: https://doi.org/10.1007/s15010-015-0821-7

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