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Last update 23 Jan 2025

Toxoplasmosis, Cerebral

Last update 23 Jan 2025

Basic Info

Synonyms

Acquired toxoplasmal meningoencephalitis, CNS TOXOPLASMOSIS, Central Nervous System Toxoplasmosis

+ [48]

Introduction

Infections of the BRAIN caused by the protozoan TOXOPLASMA gondii that primarily arise in individuals with IMMUNOLOGIC DEFICIENCY SYNDROMES (see also AIDS-RELATED OPPORTUNISTIC INFECTIONS). The infection may involve the brain diffusely or form discrete abscesses. Clinical manifestations include SEIZURES, altered mentation, headache, focal neurologic deficits, and INTRACRANIAL HYPERTENSION. (From Joynt, Clinical Neurology, 1998, Ch27, pp41-3)

Drugs associated with Toxoplasmosis, Cerebral

Azithromycin

Target

50S subunit

Mechanism

50S subunit inhibitors

Active Org.

Shinpoong Pharmaceutical Co., Ltd. [+7]

Originator Org.

Pfizer Inc.

Active Indication

Genital infection [+36]

Inactive Indication

Acne Vulgaris [+21]

Drug Highest PhaseApproved

First Approval Ctry. / Loc.

First Approval Date01 Nov 1991

Clinical Trials associated with Toxoplasmosis, Cerebral

NCT04341155

/ RecruitingPhase 2IIT

Adjunctive Dexamethasone for Cerebral Toxoplasmosis: a Double-blinded Randomized Controlled Trial

Toxoplasma gondii infects over one third of the global human population. Cerebral toxoplasmosis is the most common opportunistic infection in HIV patients resulting in up to 50% of mortality with proper treatment and 80% without it. The fatality mainly due to the brain edema resulted from the mass effect lesion. In addition of anti toxoplasmosis given, adjunctive therapy such as steroid is recommended in order to reduce brain edema, but the dose and duration of administration in cerebral toxoplasmosis has not been evaluated in a clinical trial. Adjunctive therapy given in cerebral toxoplasmosis patients still remains unclear. Moreover, its safety in immunodeficiency cases is still debatable.

Start Date16 Apr 2021

Sponsor / Collaborator

Universitas Padjadjaran

JPRN-jRCTs071180095

/ RecruitingPhase 2/3IIT

Efficacy and safety of pyrimethamine/sulfadiazine/folinate combination therapy for the treatment of disseminated toxoplasmosis and toxoplasma encephalitis - Treatment of disseminated toxoplasmosis/toxoplasma encephalitis with pyrimethamine/sulfadiazine

Start Date18 Mar 2020

Sponsor / Collaborator-

ChiCTR2000031257

/ RecruitingNot ApplicableIIT

A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections

Start Date01 Feb 2019

Sponsor / Collaborator

Chongqing Public Health Medical Center

100 Clinical Results associated with Toxoplasmosis, Cerebral

100 Translational Medicine associated with Toxoplasmosis, Cerebral

0 Patents (Medical) associated with Toxoplasmosis, Cerebral

1,755

Literatures (Medical) associated with Toxoplasmosis, Cerebral

01 Jan 2025·Central Nervous System Agents in Medicinal Chemistry

A Review of the Association between Infections, Seizures, and Drugs

Article

Author: Tolou-Ghamari, Zahra

Background:Seizures are a common presenting symptom of the central nervous system (CNS) and could occur from infections (such as toxins) or drugs.Objective:The aim of this study was to present a systematic review of the association between infections, seizures, and drugs.Methods:From their inception to 18 February 2024 relevant in-depth consequent guide approach and the evidence-based choice were selected associated with a knowledgeable collection of current, high-quality manuscripts.Results:Imbalance between inhibitory and excitatory neurotransmitters due to infections, drugs such as ticarcillin, amoxicillin, oxacillin, penicillin G, ampicillin, tramadol, venlafaxine, cyclosporine, tacrolimus, acyclovir, cellcept, the old generation of antiepileptic drugs, such as carbamazepine, phenytoin, and many other drugs could cause different stages of CNS disturbances ranging from seizure to encephalopathy. Infections could cause life-threatening status epilepticus by continuous unremitting seizures lasting longer than 5 minutes or recurrent seizures. Meningitis, tuberculosis, herpes simplex, cerebral toxoplasmosis, and many others could lead to status epilepticus. In fact, confusion, encephalopathy, and myoclonus were reported with drugs, such as ticarcillin, amoxicillin, oxacillin, penicillin G, ampicillin, and others. Penicillin G was reported as having the greatest epileptogenic potential. A high dose, in addition to prolonged use of metronidazole, was reported with seizure infection. Meropenem could decrease the concentration of valproic acid. Due to the inhibition of cytochrome P450 3A4, the combination of clarithromycin and erythromycin with carbamazepine needs vigilant monitoring.Conclusion:Due to changes in drug metabolism, co-administration of antiseizure drugs and antibiotics may lead to an enhanced risk of seizures. In patients with neurocysticercosis, cerebral malaria, viral encephalitis, bacterial meningitis, tuberculosis, and human immunodeficiency virus, the evidence-based study recommended different mechanisms mediating epileptogenic properties of toxins and drugs.

01 Dec 2024·AIDS

Longitudinal study of cognitive function in people with HIV and toxoplasmic encephalitis or latent toxoplasma infection

Article

Author: Tang, Bin ; McCutchan, J. Allen ; Heaton, Robert K. ; Bharti, Ajay R. ; Diaz, Monica M. ; Franklin, Donald ; Crescini, Melanie ; Letendre, Scott L.

Background:Neurocognitive impairment (NCI) may occur during and persist even after recovery from HIV-related central nervous system (CNS) co-infections such as toxoplasmic encephalitis (TE). The long-term cognitive effects of TE and latent toxoplomasmic infections (LTI) among persons with HIV (PWH) are unknown. We measured longitudinal effects on neurocognitive functioning in PWH with TE compared to LTI or no toxoplasmal infection.Methods:PWH (n = 345) followed in two longitudinal cohort studies underwent comprehensive neurocognitive assessments and an anti-toxoplamic immunoglobulin G (IgG) assay. Participants were classified into one of three groups: TE+ (n = 39), LTI+ (n = 34), LTI− (n = 272). The primary outcome was change in neurocognitive function between baseline and 7-year visit.Results:The mean age was 48 ± 11 years, mean educational level 13 ± 3 years, and 13% were female. TE+ patients were less likely to have undetectable viral loads (≤50 copies/ml) and had lower absolute CD4+ cell count. The TE+ group had the highest prevalence of NCI globally and in domains of verbal, executive function, learning, recall, working memory, processing speed and motor at baseline and at 7-year follow-up. Changes in longitudinal NC function over 7 years were small and did not differ significantly among all groups, except that speed of information processing improved more in TE+ compared with LTI− participants.Conclusions:PWH with a history of TE had cognitive impairment over a broad range of severity at both baseline and last follow-up. Changes in cognition from baseline to last examination in all groups were minimal and did not differ significantly among the groups with the exception of speed of information processing.

01 Dec 2024·Transplant Immunology

Combination of trimethoprim-sulfamethoxazole and mesenchymal stem cell therapy to treat toxoplasmic encephalitis after hematopoietic stem cell transplantation: A case report

Article

Author: Liu, Minyuan ; Yan, Qing ; Wang, Yi ; Kong, Lingjun ; Li, Jie ; Zhang, Senlin ; Wang, Manli ; Zhang, Weiliang ; Ji, Qi ; Yao, Yanhua ; Wu, Shuiyan ; Gao, Li ; Hu, Shaoyan ; Li, Bohan ; Liu, Hu ; Xia, Zihao

Toxoplasmosis, caused by the parasite Toxoplasma gondii, is a life-threatening infection that may occur following hematopoietic stem cell transplantation (HSCT). Toxoplasmic encephalitis (TE) is one of the most severe manifestations of this infection and often results in unsatisfactory therapeutic outcomes, especially regarding neurological damage. Recent studies have demonstrated that human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) can significantly aid in neural repair and remodeling. Furthermore, hUC-MSCs have been shown to reduce the risk of graft-versus-host disease (GVHD) associated with the reduction or discontinuation of immunosuppressive therapy. In this case report, we present a pediatric patient who developed TE as a complication of haploidentical HSCT. The patient received a combined treatment regimen of standard anti-Toxoplasma therapy and adjunctive hUC-MSC therapy. The outcomes were satisfactory. The patient regained consciousness, maintained a stable body temperature, and regained the ability to perform daily activities independently. Additionally, next-generation sequencing revealed a decrease in Toxoplasma DNA sequences in the blood and cerebrospinal fluid to undetectable levels. This case report underscores the potential of hUC-MSCs as a promising therapeutic modality for TE.

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Toxoplasmosis, Cerebral

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