Reactivation of Latent Toxoplasmosis in a Schizophrenia Patient: A Case Report

  • Wathiqah Wahid Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Che-ras, Kuala Lumpur, Malaysia
  • Anis Safirah Mohammad Zahariluddin Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Che-ras, Kuala Lumpur, Malaysia
  • Zuri Shahidii Kadir Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
  • Shalisah Sharip Department of Psychiatry, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
  • Zulkarnain Md Idris Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Che-ras, Kuala Lumpur, Malaysia
  • Emelia Osman Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Che-ras, Kuala Lumpur, Malaysia
Keywords: Toxoplasmosis; Schizophrenia; Reactivated; Serology

Abstract

Schizophrenia is a serious mental disorder characterized by chronic relapsing episodes of psychosis. The disease is multifactorial, where infections, genetic vulnerability and environmental factors are involved in the development of the illness. Toxoplasma gondii is one of the parasites that has long been known associated with schizophrenia in many studies. To date, there is growing evidence of association between T. gondii infections and schizophrenia. Herein we report a rare case of reactivated toxoplasmosis in a schizophrenia individual. This patient was incidentally diagnosed with reactivated T. gondii infection. He denied any symptoms of toxoplasmosis but experienced a mild psychiatric auditory hallucination. Serology test for T. gondii immunoglobulin antibodies measured a high positive IgG titer (135.9 IU/ml) and negative for IgM. Interestingly, nested PCR exhibited a positive result for the type I strain of T. gondii dense granular (GRA) 7 gene (GRA7). This case highlights the detection of probable reactivation of toxoplasmosis in an immunocompetent schizophrenic patient without psychiatric treatment-resistant and remains asymptomatic for toxoplasmosis. Both serology and molecular tools have been a helpful aid in establishing the diagnosis. Nonetheless, early detection as in this case may aid the patient management in the future.

Published
2021-09-06
Section
Articles