Meeting abstract

https://doi.org/10.24869/spsih.2026.188

First-Episode Psychosis With Neuroradiological Changes and Toxoplasma Gondii Serology of Unclear Clinical Significance: A Case Report

Filip Kralik ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia *
Valentin Kordić ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
Ena Bandov ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia
Sandra Anton ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
Dunja Degmečić ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
Josipa Ivanušić Pejić ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
Anamarija Petek-Erić ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia
Zoran Čavajda ; Clinic for Psychiatry, University Hospital Centre Osijek, J. Huttlera 4, 31000 Osijek, Croatia; Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, Josipa Huttlera 4, 31000 Osijek, Croatia

* Corresponding author.

Abstract

Toxoplasmosis caused by the parasite Toxoplasma
gondii in immunocompetent individuals is most
often asymptomatic or mild; however, reactivation
of latent infection, especially when the central
nervous system is involved, can mimic primary
psychiatric disorders, including psychotic
symptomatology. The aim of this paper is to present
a case of a patient whose first psychotic episode
was accompanied by clinical, laboratory, and
radiological findings that raised the question of
a possible infectious component underlying the
psychiatric decompensation. We present the case
of a 41-year-old man, with no known psychiatric
heredity and no prior psychiatric treatment, who was hospitalized due to a first psychotic episode
characterized by delusional ideas of influence and
persecution, marked somatic preoccupation with
illness, significant weight loss, and a pronounced
sleep disturbance immediately before admission.
Brain MRI with contrast showed inflammatory
changes of the meninges of unclear etiology. Extensive
microbiological analysis of the cerebrospinal
fluid, including PCR for West Nile virus,
Usutu virus, cytomegalovirus, and tick-borne
encephalitis virus, together with borderline IgM
for West Nile virus and negative IgG, did not microbiologically
confirm the causative agent of the
inflammation. Serum testing demonstrated exposure
to Toxoplasma gondii with high-avidity IgG,
which, according to the infectious disease specialist’s
assessment, indicated a remote rather than
an acute infection. Thrombophilia workup and
continued follow-up by a neurologist and transfusion
medicine specialist, including monitoring
of previously noted cortical vein thrombosis,
remained unremarkable during hospitalization.
With the introduction of antipsychotic and anxiolytic
therapy, a rapid and marked regression of
psychotic and affective symptoms was achieved,
and the patient was discharged home with continued
outpatient psychiatric treatment. This
case illustrates the diagnostic complexity of a first
psychotic episode accompanied by neuroradiological
changes of unclear etiology and underscores
the value of multidisciplinary evaluation and
cautious interpretation of serological findings,
including Toxoplasma gondii, in the context of the
differential diagnosis of acute-onset psychotic
states.

Keywords

first; psychosis; Toxoplasma gondii

Hrčak ID:

352321

URI

https://hrcak.srce.hr/352321

Publication date:

15.6.2026.

Article data in other languages: croatian

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