TOXOPLASMIC MENINGITIS: OPHTHALMOLOGICAL AND NEUROLOGICAL SEQUELATES

Abstract

Meningitis caused by Toxoplasma gondii, an intracellular parasite, has been associated with significant ocular and neurological sequelae. This condition primarily affects immunocompromised individuals, such as those with human immunodeficiency virus (HIV) infection. Invasion of the central nervous system by Toxoplasma gondii can lead to severe inflammation and tissue damage, resulting in long-term visual and neurological impairments. Toxoplasmic meningitis often presents with nonspecific symptoms, including headache, fever, and altered mental status. However, the distinguishing feature lies in the potential for ocular involvement, which can manifest as chorioretinitis, uveitis, and optic neuritis. These ocular complications can lead to vision loss and impact the patient's overall quality of life. Objective: To comprehensively assess the existing body of knowledge on the ocular and neurological sequelae of Toxoplasma gondii meningitis. Methodology: A systematic search was performed in the PubMed, Scielo and Web of Science databases to identify relevant articles and studies. The search strategy used a combination of five main descriptors: "toxoplasmosis", "meningitis", "ocular complications", "neurological sequelae" and "visual results". Inclusion criteria focused on studies that examined the association between Toxoplasma gondii meningitis and subsequent ocular and neurological complications. Results: 16 articles were selected. The review provided a substantial body of literature indicating that Toxoplasma gondii meningitis is indeed associated with a variety of ocular and neurological sequelae. Ocular complications included chorioretinitis, uveitis, vitritis, and optic neuritis, often leading to irreversible visual impairments. Neurologically, patients often had focal deficits, seizures, and cognitive dysfunction, which could persist even after successful treatment of the acute infection. Conclusion: The systematic review of the literature highlights the intricate relationship between Toxoplasma gondii meningitis and its profound ocular and neurological sequelae. The convergence between infection-induced inflammation and tissue damage in the brain and eyes underscores the need for increased clinical awareness and timely intervention. By understanding the complexities of this condition, healthcare professionals can be better equipped to anticipate, diagnose and manage the potential long-term visual and neurological outcomes in affected patients.