Background

Toxoplasmosis is a zoonosis caused by the protozoan Toxoplasma gondii. In immunocompetent patients the infection is usually benign. However, cases of severe and even lethal primo-infections are regularly reported in South America. In contrast, data from tropical Africa are fragmentary.

Methods

Data for French cases of severe toxoplasmosis acquired between 2013 and 2018, in tropical Africa and among immunocompetent patients were collected retrospectively in 2018.

Results

Four male patients with a mean age of 34-years were identified. All infections originated in West or Central Africa. The clinical presentations were heterogeneous: two patients had severe disseminated toxoplasmosis, of which one presented with chorioretinitis associated with myositis and the other with febrile pneumopathy; one patient presented with post-infectious acute cerebellar ataxia and the final case had general symptoms and skin manifestations. The diagnosis of acute toxoplasmosis was confirmed by serology in four patients. Molecular diagnosis confirmed T. gondii infection in three patients with Africa 1 as the dominant genotype. The infection was cured with anti-infective treatment in all four patients. Ocular sequelae were reported in the two patients with chorioretinitis.

Conclusions

Imported cases of severe toxoplasmosis in immunocompetent patients are rare in France. However, this aetiology should be evoked rapidly in a patient with a severe infectious syndrome who has recently visited or originated from tropical Africa.

中文翻译：

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从非洲热带地区进口的具有免疫能力的患者的严重弓形虫病：一个病例系列。

背景

弓形虫病是由刚体弓形虫弓形虫引起的人畜共患病。在具有免疫能力的患者中，感染通常是良性的。但是，南美定期报告严重甚至致命的原发感染病例。相反，来自热带非洲的数据是零碎的。

方法

在2018年至2018年期间，回顾性收集了2013年至2018年之间在热带非洲和免疫活性患者中法国重度弓形虫病病例的数据。

结果

确定了四名平均年龄为34岁的男性患者。所有感染都起源于西非或中非。临床表现各不相同：2例患有严重的弥漫性弓形虫病，其中1例伴有脉络膜视网膜炎并发肌炎，另一例伴有高热性肺病。一名感染后急性小脑共济失调的患者，最后一例具有一般症状和皮肤表现。血清弓形虫病确诊为急性弓形虫病的四名患者。分子诊断证实三名非洲人1为主要基因型的弓形虫感染。所有四名患者均通过抗感染治疗得以治愈。报道了两名患有脉络膜视网膜炎的患者的眼后遗症。

结论

在法国，很少有在免疫能力强的患者中输入严重弓形虫病的病例。但是，这种病因应在最近到过热带非洲或从热带非洲来过的患有严重传染综合症的患者中引起。