Protein profile of purified plasma- and aqueous humor-derived extracellular vesicles from patients with ocular toxoplasmosis

ABSTRACT Purpose: To characterize the extracellular vesicle protein cargo in the aqueous humor and plasma of patients with ocular toxoplasmosis. Methods: Aqueous humor and plasma were collected from six patients with active ocular toxoplasmosis and six patients with cataract. Extracellular vesicles were isolated, and western blotting and mass spectrometry were performed for protein analysis. Results: All plasma samples from patients with ocular toxoplasmosis and cataract were positive for the tetraspanins CD63 and TSG101. However, the aqueous humor from patients with ocular toxoplasmosis was positive only for CD63. Sixty-seven new unreported proteins were identified in the aqueous humor and plasma of patients with the ocular toxoplasmosis and cataract. Of the 67 proteins, 10 and 7 were found only in the cataract and ocular toxoplasmosis groups, respectively. In general, these proteins were involved in immune system activation and retina homeostasis and were related to infections and retina-associated diseases. Conclusion: The distinct protein signatures between ocular toxoplasmosis and cataract may be helpful in the differential diagnosis of ocular toxoplasmosis. However, more studies are needed to better understand the role of these proteins in the pathogenesis of ocular toxoplasmosis.

Seroprevalence and Risk Factors for Toxoplasma gondii Infection in Women of Reproductive Age in Nigeria in 2018.

Congenital transmission of Toxoplasma gondii can occur when a woman becomes infected for the first time during or just before pregnancy. Toxoplasma gondii in the fetus can lead to miscarriage, stillbirth, ocular or neurological abnormalities at birth, or progressive visual, hearing, motor, and cognitive deficiencies. The national seroprevalence of T. gondii infection in Nigeria was previously unknown. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey collected demographic, socioeconomic, and HIV-related data and stored blood specimens with consent for future analysis for other pathogens of public health importance. We evaluated toxoplasmosis seropositivity and risk factors in a sample of 44,269 women of reproductive age (WRA) between 15 and 44 years. The national T. gondii seroprevalence among WRA was 26.8% (95% CI: 25.8-27.7%). We found that WRA from all 36 states and the Federal Capital Territory had T. gondii exposure. Seroprevalence was higher in 25- to 44-year-olds than in 15- to 24-year-olds. A similar proportion of pregnant and nonpregnant women were seropositive. Increased odds of seropositivity were associated with unimproved toilet facilities and drinking water sources, being in a higher wealth quintile, and primary and secondary education compared with no education. Decreased odds of seropositivity were associated with living in an urban area and owning livestock. This study provides the first-ever national seroprevalence estimate for WRA in Nigeria. Although information on known risk factors for toxoplasmosis (e.g., consumption of undercooked meat, cat ownership) was not collected, future studies could further investigate potential risk factors to inform the development of effective toxoplasmosis prevention measures.

Serological and molecular detection of Toxoplasma gondii infection in apparently healthy horses in eastern of Spain.

Toxoplasmosis is one of the most common parasitic zoonoses and represents a significant health risk for humans, especially for immunodeficient patients. The main transmission route is by oral uptake of oocysts and consumption of undercooked meat of infected animals. Different species have been evaluated as possible reservoirs of the parasite, but few studies have been carried out to examine the role of horses in transmission of the disease. Given the proximity of these animals to humans and the widespread consumption of their meat in many countries, including the Mediterranean basin, it is important to determine the prevalence of T. gondii infection in this species. In this study, blood samples from 105 horses were collected and the presence of T. gondii was evaluated by serological and molecular methods. Antibodies against T. gondii of 12 horses (11.43%) were detected by enzyme-linked immunosorbent assay (ELISA), whereas 29 horses (27.62%) showed positive for PCR. Seroprevalence was related to use of the animals, being higher in horses used for dressage than in others. Purebreds had higher seroprevalence than crossbred animals. No differences between breed, sex or age were found. The results of this study confirm the presence of T. gondii infection in horses, highlighting the need to analyse the meat of this species before human consumption and to control of this infection in horses, as they could be an important reservoir of this zoonotic parasite.

Complications of ventriculoperitoneal shunts: Infection and exposure in hydrocephalus patients: A case series.

Background: Ventriculoperitoneal shunt (VPS) is an effective intervention for managing hydrocephalus; however, various complications may arise, one of which is infection due to shunt exposure. In this study, we report the incidence, risk factors, clinical presentation, and management strategies of four cases of shunt exposure in patients with hydrocephalus. Case Description: The first case involves a 1-year-10-month-old female who underwent her initial VPS placement at 7 months old due to hydrocephalus. The second case is a 3-month-old female who had a VPS placed at 20 days old for obstructive hydrocephalus and ventriculomegaly secondary to toxoplasmosis. The third case is a 15-year-old female who received a VPS due to a cerebral abscess with a prior history of tuberculous meningoencephalopathy. The fourth case is a 38-year-old male who underwent VPS placement for hydrocephalus. Two years post-intervention, the fourth patient was diagnosed with VPS exposure and subsequently underwent shunt removal. Conclusion: The identification of risk factors and clinical symptoms in patients, supported by ancillary examinations such as cerebrospinal fluid analysis, can predict the incidence of VPS infections. Bacterial VPS infections can be managed with appropriate antibiotics tailored to the specific bacterial species. However, in certain cases, surgical removal of the VPS may be considered as a measure to eradicate infectious pathogens.

Detection of Congenital Toxoplasmosis and Cytomegalovirus Infections Using Paired Sample Serodiagnosis from Suspected Cases at a Tertiary Teaching Hospital in Malaysia.

Background: Congenital toxoplasmosis and congenital cytomegalovirus (cCMV) infections are noteworthy in Malaysia and can cause serious health problems in neonates. The prompt and effective detection and treatment related to both illnesses may mitigate the possibility of adverse consequences from both infections. Methods: A total of 219 neonates with suspected clinical indications of congenital toxoplasmosis and/or cCMV infections from January 2022 to December 2022 were enrolled. The first samples for IgM and IgG antibodies were screened by electrochemiluminescence immunoassay. For positive results indicative of congenital toxoplasmosis and cCMV infections, second serum samples were requested and tested within a period of 2-4 weeks after testing the first sample. Results: From the 219 first serum samples, the overall seroprevalence of congenital toxoplasmosis antibodies in suspected cases was 53%; meanwhile, the overall seroprevalence of cCMV in the suspected cases was 98.6%. The results of the paired serum sample collected for investigating congenital toxoplasmosis cases revealed that 47% of the cases presented no serological evidence of exposure while the remaining 53% of cases might have acquired passive immunity from the mother. For cCMV, the number of cases with no serological evidence of exposure was 1.4%, whereas acute infection was 1.8% and possible passive immunity from the mother represented 96.8%. Conclusion: This study found a high seroprevalence of congenital toxoplasmosis and cCMV infections, probably because they are suspected cases. This study also indicates that using paired sample analysis in the categorisation of cases can aid in accurate diagnosis and more effective treatment.

Toxoplasma gondii DNA in Tissues of Anadromous Arctic Charr, Salvelinus alpinus, Collected From Nunavik, Québec, Canada.

BACKGROUND: Toxoplasma gondii is a very common zoonotic parasite in humans and animals worldwide. Human seroprevalence is high in some regions of Canada's North and is thought to be associated with the consumption of traditionally prepared country foods, such as caribou, walrus, ringed seal and beluga. While numerous studies have reported on the prevalence of T. gondii in these animals, in the general absence of felid definitive hosts in the North there has been considerable debate regarding the source of infection, particularly in marine mammals. It has been proposed that fish could be involved in this transmission. AIMS: The objectives of the present study were to perform a targeted survey to determine the prevalence of T. gondii DNA in various tissues of anadromous Arctic charr sampled in Nunavik, Québec, and to investigate the possible role of this commonly consumed fish in the transmission of infection to humans and marine mammals in Canada's North. METHODS AND RESULTS: A total of 126 individual Arctic charr were sampled from several sites in Nunavik, and various tissues were tested for the presence of T. gondii DNA using PCR. Overall, 12 out of 126 (9.5%) Arctic charr tested in the present study were PCR-positive, as confirmed by DNA sequencing. Brain tissue was most commonly found to be positive, followed by heart tissue, while none of the dorsal muscle samples tested were positive. CONCLUSIONS: Although the presence of T. gondii DNA in brain and heart tissues of Arctic charr is very intriguing, infection in these fish, and their possible role in the transmission of this parasite to humans and marine mammals, will need to be confirmed using mouse bioassays. Arctic charr are likely exposed to T. gondii through the ingestion of oocysts transported by surface water and ocean currents from more southerly regions where the definitive felid hosts are more abundant. If infection in Arctic charr can be confirmed, it is possible that these fish could play an important role in the transmission of toxoplasmosis to Inuit, either directly through the consumption of raw fish or indirectly through the infection of fish-eating marine mammals harvested as country foods.

The quality and characteristics of bovine sperm are compromised by Toxoplasma gondii antigens, impacting in in vitro bull fertility.

Studies in various species have demonstrated different results on the effects of T. gondii infection on sperm quality. It has also been demonstrated that in some stages of the disease, there is elimination of cellular debris or even the intact parasite in the semen. The present work aimed to evaluate the in vitro effects of the presence of soluble T. gondii antigens in bovine semen on sperm integrity. The spermatozoa were treated with T. gondii antigens in double serial dilutions classified as high, medium and low doses (8, 4, 2 µg/ml) in "TALP-Sperm" and "TALP-Fert" media. The results showed that T. gondii antigens affect sperm motility and mitochondrial activity, and cause changes in sperm chromatin integrity, as well as damage to the sperm membrane and acrosome. Finally, spermatozoa treated with T. gondii antigens were evaluated in the in vitro production of embryos (IVEP). The use of semen contaminated with antigens in IVEP routines did not lead to a decrease in the fertilization of oocytes, as sperm undergo selection before in vitro fertilization, which eliminates the most altered sperm. However, early embryonic development was affected, probably by structural changes that were not eliminated in the selection process. The results demonstrated that the presence of soluble T. gondii antigens in bovine semen alters sperm integrity and vital characteristics for the fertilization process and embryonic development and therefore causes fertility problems in males.

Toxoplasma gondii Infection of Alzheimer's Disease Mice Reduces Brain Amyloid Density Globally and Regionally.

BACKGROUND: Toxoplasma gondii infection of Alzheimer's disease model mice decreases amyloid ß plaques. We aimed to determine if there is a brain regional difference in amyloid ß reduction in the brains of T. gondii-infected compared to control mice. METHOD: Three-month-old 5xFAD (AD model) mice were injected with T. gondii or with phosphate-buffered saline as a control. Intact brains were harvested at 6 weeks postinfection, optically cleared using iDISCO+, and brain-wide amyloid burden was visualized using volumetric light-sheet imaging. Amyloid signal was quantified across each brain and computationally mapped to the Allen Institute Brain Reference Atlas to determine amyloid density in each region. RESULTS: A brain-wide analysis of amyloid in control and T. gondii-infected 5xFAD mice revealed that T. gondii infection decreased amyloid burden in the brain globally as well as in the cortex and hippocampus, and many daughter regions. Daughter regions that showed reduced amyloid burden included the prelimbic cortex, visual cortex, and retrosplenial cortex. The olfactory tubercle, a region known to have increased monocytes following T. gondii infection, also showed reduced amyloid after infection. CONCLUSIONS: T. gondii infection of AD mice reduces amyloid burden in a brain region-specific manner that overlaps with known regions of T. gondii infection and peripheral immune cell infiltration.

Relationship between nutritional condition and causes of death in beluga whales Delphinapterus leucas from the St. Lawrence estuary, Quebec, Canada.

Carcasses of endangered beluga whales Delphinapterus leucas from the St. Lawrence Estuary, Canada, have been examined consistently since 1983 to determine causes of death. The objective of this study is to compare the nutritional condition of belugas that died of different causes. Previously published categories of death were refined to discriminate acute from chronic pathological processes. Bayesian linear models were used to predict cause of death from the scaled mass index (SMI). Causes of death were as follows: 'bacterial diseases', 'verminous pneumonia', 'toxoplasmosis', 'other parasitic diseases', 'other infectious diseases', 'trauma-entrapment', 'other noninfectious diseases', 'dystocia-postpartum complications', 'neonatal mortality', 'cancer', 'primary starvation' and 'undetermined'. The models predicted a lower nutritional condition for the 'neonatal mortality' in belugas <290 cm in length and for 'primary starvation' and 'verminous pneumonia' categories for belugas ≥290 cm. Belugas that died from 'dystocia-postpartum complications' or from 'undetermined causes' had a higher-than-average SMI. Animals in the 'trauma-entrapment' category did not exhibit the highest nutritional condition, which was unexpected since individuals that died from trauma or entrapment are often used as references for optimal nutritional condition in other cetacean populations. Females that died from dystocia and postpartum complications were in similar nutritional condition as females dead from other causes during, or shortly after, pregnancy. This suggests that these females are not obese, ruling out a possible cause of dystocia. Although studying dead animals biases results toward low nutritional condition, our findings support the link between chronic pathological processes and poorer nutritional condition in belugas.

Trends of Toxoplasma gondii and common transfusable venereal infections among blood donors in Menoufia Province, Egypt.

Blood transfusion has a hazard of transmission of many pathogens, including Toxoplasma gondii (T. gondii) and other venereal infections. It is crucial to conduct epidemiological surveillance to detect the prevalence of these pathogens. The study aimed to assess the seroprevalence of T. gondii and common transfusable venereal infections among healthy blood donors in Menoufia Province, Egypt, and identify associated risk factors. Four hundred twenty individuals were recruited between January and April 2023 for cross-sectional descriptive research from the blood banks of Menoufia University medical hospitals. Collected blood samples were screened for anti-T. gondii IgM and IgG, HBsAg, anti-HCV antibodies, HIV p24 antigen and anti-HIV antibodies, and anti-Treponema pallidum antibodies. 46 (11.0%) and 22 donors (5.2%) individuals tested positive for anti-T. gondii IgG with a 95% CI (8.3-14.6) and IgM with a 95% CI (3.5-8.1), respectively, while one patient (0.2%) was positive for both antibodies. Regarding venereal infections, 12 (2.9%) were positive for HBV, 6 (1.4%) were positive for HCV, 7 (1.7%) were positive for HIV, and none of the tested population showed positivity for syphilis. Female gender, consumption of raw meat, agricultural environment, poor awareness about T. gondii, and blood group type (especially AB and O groups) were identified as independent risk factors for T. gondii infection. The study highlights the importance of testing blood donors for T. gondii and common transfusable venereal illnesses. Starting health education programs and preventative measures, such as suitable meat handling and cleanliness practices, is critical for minimizing the occurrence of these illnesses. Larger-scale additional study is advised to confirm these results and provide guidance for public health initiatives.

Anti-Toxoplasma gondii effects of XYP1-derived peptides and regulatory mechanisms of XYP1.

BACKGROUND: Toxoplasmosis, caused by Toxoplasma gondii , poses serious health issues for humans and animals. Individuals with impaired immune systems are more susceptible to severe toxoplasmosis. Pregnant women infected by T. gondii can face the possibility of birth defects and miscarriages. While pyrimethamine and sulfadiazine are commonly used drugs in clinical practice, concerns over their side effects and resistance are on the rise. A spider peptide XYP1 isolated from Lycosa coelestis had potent anti-T. gondii effects, but it had a high synthesis cost and strong cytotoxicity. METHODS: This study intended to modify XYP1 for producing derived peptides via amino acid truncation and substitution. The anti-T. gondii effect was evaluated by trypan blue staining assay and killing experiment of RH strain tachyzoites. The CCK8 and hemolysis assays were used to compare their safeties. The morphological changes of T. gondii were observed by scanning electron microscope and transmission electron microscope. In addition, the mechanism of XYP1 against T. gondii through RNA-sequencing was further explored. RESULTS: In vivo and in vitro experiments revealed that XYP1-18 and XYP1-18-1 had excellent anti-T. gondii activity with lower cytotoxicity and hemolysis activity than XYP1. XYP1, XYP1-18, and XYP1-18-1 were able to disrupt the surface membrane integrity of T. gondii tachyzoites, forming pores and causing the disruption of organelles. Furthermore, RNA-sequencing analysis indicated that XYP1 could stimulate the host immune response to effectively eliminate T. gondii and lessen the host's inflammatory reaction. CONCLUSIONS: XYP1-18 had lower cytotoxicity and hemolysis activity than XYP1, as well as significantly extending the survival time of the mice. XYP1 played a role in host inflammation and immune responses, revealing its potential mechanism. Our research provided valuable insights into the development and application of peptide-based drugs, offering novel strategies and directions for treating toxoplasmosis.

Assessing leptospirosis and toxoplasmosis seropositivity in wild boars (Sus scrofa): Implications for public and animal health in Southern Brazil.

Leptospirosis and toxoplasmosis are re-emerging zoonosis caused by infection with pathogenic spirochaetes of Leptospira and the protozoa Toxoplasma gondii, respectively. Wild boars (Sus scrofa), an exotic invasive species in Brazil, could play a role in the diseases' epidemiological cycles, but this issue is still unexplored. This study aimed to evaluate the Leptospira spp. and T. gondii seropositivity in wild boars in Rio Grande do Sul state, south Brazil. Of evaluated animals, 16% (13/80) and 85% (52/61) had antibodies to T. gondii and Leptospira spp., respectively. Sex, weight, age, hunt location and season of hunt were evaluated by their association with seropositivity for both pathogens, but none of them had statistical significance. This study revealed that wild boars should be considered as a potential source of Leptospira spp. and T. gondii dissemination for humans and animal species in shared environments in Rio Grande do Sul state.

High level of immunoglobulin G targeting mycoplasma or cytomegalovirus in the newborn increases risk of ADHD.

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder typically detected in childhood. Although ADHD has been demonstrated to have a strong genetic component, environmental risk factors, such as maternal infections during pregnancy, may also play a role. We therefore measured the immunological response to 5 abundant microorganisms (Toxoplasmosis Gondii, cytomegalovirus (CMV), Herpes Simplex Virus 1, Epstein Barr Virus and mycoplasma pneumoniae) in newborn heel prick samples of 1679 ADHD cases and 2948 matching controls as part of the iPSYCH Danish case-cohort study. We found an association between high anti-CMV (OR 1.30, 95 % CI [1.09,1.55], p = 0.015) and anti-mycoplasma (OR 1.30, 95 % CI [1.07,1.59], p = 0.037) signal and those newborns later being diagnosed with ADHD. The risk estimate remained increased when controlling for ADHD polygenic risk score as well as penicillin prescriptions. We saw a dose-response association with the amount of positive anti-microorganism titers increasing the risk of being diagnosed with ADHD later in life (p = 0.01 for the trend), suggesting that the more activated the immune system is prior to or at birth, the higher the risk is for a later diagnosis with ADHD. If the associations are causal, they emphasize the importance of a healthy life style during pregnancy to reduce the risk of infections when pregnant and the associated risks for the child.

Toxoplasmosis and Chlamydophilosis in Small Ruminant Farms in Cameroon: Knowledge, Attitudes, Practices, and Perception of Zoonotic Risks of Farmers.

Zoonotic abortive diseases represent a significant health and economic risk for national public health. This cross-sectional survey was conducted from April to October 2021 among 200 selected small ruminant farmers in the three northern regions of Cameroon. Data collection was done through questionnaires administered by exchange with the herder, and responses were coded and recorded on an Excel spreadsheet. The data were then analyzed with R software, version 2.13.0. An ANOVA test was used to assess significant differences in mean of Knowledge, Attitudes, Practices, and Perception of zoonotic risks (KAPP) scores between regions. Pearson correlations were used to calculate the association between KAPP scores within regions. Small ruminant farmers surveyed had low mean scores for knowledge of abortive toxoplasmosis and chlamydophilosis (0.1 ± 0.2), desirable attitude (0.32 ± 0.07), appropriate practice (0.36 ± 0.13) in managing abortion, and positive perception of zoonotic risks of toxoplasmosis and chlamydophilosis in small ruminants (0.12 ± 0.33), respectively. KAPP was significantly (P < 0.01) and positively associated with knowledge (r = 0.98) and risk perception (r = 0.99). However, attitudes (r = 0.06), practices (r = 0.05), and risk perception of toxoplasmosis (r = 0.07) and chlamydophilosis (r = 0.08) were not associated with farmers' knowledge. This study revealed significant knowledge gaps, low levels of desired attitudes, and high-risk behavioral practices. These results therefore call for capacity building of health professionals and farmers to better integrate the One Health concept in the management of neglected zoonotic diseases.

Inverted U-shaped relationship between serum 25-hydroxyvitamin D concentrations and Toxoplasma gondii infection: a cross-sectional study.

Background: Toxoplasma gondii (T. gondii) is a widespread zoonotic parasite transmitted through contaminated food or water. It poses a significant public health threat, especially to pregnant women and immunocompromised individuals. 25-Hydroxyvitamin D [25(OH)D] plays a critical role in regulating both innate and adaptive immune responses, particularly in its anti-infective capacity. However, the relationship between serum 25(OH)D concentrations and T. gondii infection remains uncertain. Methods: We analyzed the data from the National Health and Nutrition Examination Survey (NHANES) spanning 2009-2014 to explore the association between serum 25(OH)D concentrations and T. gondii infection. Extensive demographic, comorbidity, and dietary data were collected. The status of T. gondii infection was determined using serum anti-IgG antibodies. Serum 25(OH)D levels were measured using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). In addition, weighted logistic regression and restricted cubic spline analyses were performed. Results: Our analysis included 10,157 participants (mean [SE] age, 45.38 [0.39] years; 49.73% female) who met the inclusion criteria. Serum 25(OH)D levels were categorized into quintiles, with the second quintile serving as the reference group. The final model, adjusted for age, sex, race, education level, poverty income ratio, body mass index, smoking status, hypertension, diabetes, chronic kidney disease, depression, physical activity, alcohol intake, seasonal testing, and dietary vitamin D, revealed the following adjusted odds ratios (ORs) for the quintiles: 0.75 (95% confidence interval [CI]: 0.60-0.93) for the first, 0.87 (95% CI: 0.69-1.10) for the third, 0.75 (95% CI: 0.58-0.95) for the fourth, and 0.66 (95% CI: 0.49-0.91) for the fifth. Additionally, a restricted cubic spline analysis revealed an inverted U-shaped relationship between serum 25(OH)D and T. gondii infection, with an inflection point at approximately 51.29 nmol/L. Odds ratios to the left and right of the inflection point were 1.17 (95% CI: 1.03-1.32) and 0.94 (95% CI, 0.90-0.98) per 10 nmol/L, respectively. Conclusion: Our study uncovers an inverted U-shaped relationship between serum 25(OH)D concentrations and T. gondii infection, with an inflection point around 51.29 nmol/L.

Inflammatory response and parasite regulation in acute toxoplasmosis: the role of P2X7 receptor in controlling virulent atypical genotype strain of Toxoplasma gondii.

Toxoplasmosis is a globally significant disease that poses a severe threat to immunocompromised individuals, especially in Brazil, where a high prevalence of virulent and atypical strains of Toxoplasma gondii is observed. In 1998, the EGS strain, exhibiting a unique infection phenotype, was isolated in Brazil, adding to the complexity of strain diversity. The P2X7 receptor is critical in inflammation and controlling intracellular microorganisms such as T. gondii. However, its genetic variability can result in receptor dysfunction, potentially worsening susceptibility. This study investigates the role of the P2X7 receptor during acute infection induced by the EGS atypical strain, offering insight into the mechanisms of T. gondii infection in this context. We infected the female C57BL/6 (WT) or P2X7 knockout (P2X7-/-) by gavage. The EGS infection causes intestinal inflammation. The P2X7-/- mice presented higher parasite load in the intestine, spleen, and liver. The absence of the P2X7 receptor disrupts inflammatory cell balance by reducing NLRP3, IL-1ß, and Foxp3 expression while increasing IFN-γ expression and production in the intestine. In the liver, P2X7-/- animals demonstrate diminished inflammatory infiltrate within the portal and lobular regions concurrent with an enlargement of the spleen. In conclusion, the infection of mice with the EGS strain elicited immune alterations, leading to acute inflammation and cytokine dysregulation, while the P2X7 receptor conferred protection against parasitic proliferation across multiple organs.

Tumefactive Multiple Sclerosis: The Lethal Chameleon.

Tumefactive multiple sclerosis (TMS) is a rare variant of multiple sclerosis that presents with a large demyelinating lesion in the central nervous system, accompanied by peripheral ring-like enhancement, perilesional oedema and mass effect. We report a case of a 59-year-old woman who was admitted to the hospital with a four-day history of somnolence, muscle weakness in her left extremities and ultimately, loss of consciousness. Over the following 48 hours, the patient's condition worsened with progressive consciousness impairment. Although the results of the initial head computed tomography (CT) scan supported the diagnosis of a multifocal ischaemic stroke, toxoplasmosis was proposed as the most credible diagnostic hypothesis by brain magnetic resonance imaging (MRI). Due to the adverse clinical progression following the initiation of targeted therapy and inconclusive investigation, a brain biopsy was performed, which was indicative of active TMS in a subacute phase. The patient was started on plasmapheresis and natalizumab along with corticosteroids, with a very good response. In conclusion, we report a biopsy-proven TMS diagnosis in a patient that clinically mimicked an acute stroke and was radiographically confounded with intracranial toxoplasmosis. It highlights that TMS is an uncommon neurological demyelinating disease that is often misdiagnosed. It also emphasises the importance of establishing an accurate differential diagnosis to promptly initiate aggressive immunosuppressive treatment, which may result in a more favourable prognosis. LEARNING POINTS: Tumefactive multiple sclerosis is an uncommon variant of multiple sclerosis that presents a substantial diagnostic challenge due to its potential to resemble the clinical and radiological characteristics of other central nervous system (CNS) pathologies, including neoplasms, granulomatous diseases, abscesses and vasculitis.Despite the fact that multimodal imaging studies may help narrow the differential diagnosis, a biopsy is often required to reach a definitive diagnosis and should not be delayed.Awareness of this condition among non-neurologists is critical since a timely and accurate diagnosis prompts aggressive immunomodulatory treatments that may delay a second demyelinating event or progression to clinically definite multiple sclerosis.

Seropositivity for Toxoplasma gondii in cats with clinical signs and living in households with women of childbearing age.

Toxoplasmosis caused by Toxoplasma gondii is a protozoal zoonosis with high sanitary risk for pregnant women and immunocompromised people. Felids, including domestic cats, are the only definitive hosts of T. gondii. They shed oocysts which, in the environment, become infectious for a wide range of animals, including humans, acting as intermediate hosts. This study evaluated the frequency of acute toxoplasmosis in domestic cats with compatible clinical signs and living in households with women of childbearing age. Individual serum samples were collected from 150 cats and analyzed for IgM and IgG against T. gondii. Statistical analyses were performed to evaluate associations between seropositivity and potential risk factors. Overall, 31 cats (20.7 %) were seropositive for anti-T. gondii antibodies, i.e. 9 (6.0 %) for IgM, 17 (11.3 %) for IgG and 5 (3.3 %) for both. The cats showed different combinations of clinical pictures. The following statistically significant associations were found: male sex and positivity for IgM and/or IgG (p=0.0248; OR= 0.3537; 95 % CI= 0.1528-0.8675), presence of 2 or more clinical signs and positivity to IgM only (p=0.0003; OR= +infinity; 95 % CI= 3.924 to +infinity), presence of either neurological signs (p=0.0025; OR= 13.30; 95 % CI= 3.409-61.39) or ocular signs (p=0.0228; OR= 5.835; 95 % CI= 1.631-22.37) and positivity to IgM only, presence of gastrointestinal signs and positivity to IgG only (p=0.0083; OR= 5.508; 95 % CI= 1.503-18.54). Male sex also resulted a possible risk factor in the binomial logistic regression (p= 0.011; OR= 3.336; 95 % CI= 1.131-8.44). These results indicate that cats living with women of childbearing age are at risk of infection with T. gondii. The presence of certain clinical signs can be helpful in identifying recent and/or current infections using laboratory analyses. Awareness on toxoplasmosis should be kept high to protect animal and public health.