Cerebral Toxoplasmosis in Newly Diagnosed Cirrhosis Patient: A Case Report

Cerebral toxoplasmosis is an infection caused by the obligate intracellular parasite Toxoplasma gondii. This condition is frequently discovered in HIV/AIDS patients and is associated with high mortality and morbidity. Nevertheless, Cerebral toxoplasmosis can also be found in a patient with cancer, stem cell/organ transplantation, immunosuppressive therapy, or other immunodeficiency disorder as in this case is cirrhosis. Liver damage will lead to decreased cellular immunity mediated by T cells and macrophages, as well as decreased activity of type 1 cytokines (IL-12 and IFN-γ) which are needed to eliminate T.gondii. Several studies have reported this parasite is found in 20 % - 90 % of patients with cirrhosis through IgG and PCR tests. The manifestations of cerebral toxoplasmosis are decreased consciousness, headaches, cerebral dysfunction, fever, seizures, dementia, or impaired motor function. Diagnosis of cerebral toxoplasmosis is considered from clinical findings, CT scan, or MRI of the brain along with serological values. This study will discuss about cerebral toxoplasmosis in cirrhosis patients in the form of case report.