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Bipolar Disorder With Psychotic Features and Ocular Toxoplasmosis: A Possible Pathogenetic Role of the Parasite?

Del Grande, Claudia MD; Contini, Carlo MD; Schiavi, Elisa MD; Rutigliano, Grazia MD; Maritati, Martina MD; Seraceni, Silva PhD; Pinto, Barbara Dr, Sci; Dell’Osso, Liliana MD, PhD; Bruschi, Fabrizio MD

The Journal of Nervous and Mental Disease: March 2017 - Volume 205 - Issue 3 - p 192–195
doi: 10.1097/NMD.0000000000000496
Brief Report

Recent evidence suggests the involvement of Toxoplasma gondii infection in the emergence of psychotic and affective disorders. In this report, we describe the case of a young Brazilian woman affected by recurrent ocular toxoplasmosis and presenting with a manic episode with psychotic features in the context of a diagnosis of Bipolar Disorder (BD), type I. We observed a relationship between ocular manifestations and the clinical course of bipolar illness, confirmed by molecular analyses (nested-PCR), as well as by the high level of T. gondii specific IgG. This case report is the first showing the presence of circulating parasite DNA at the time of occurrence of psychiatric symptoms, thus providing further support for a possible role of the parasite in the pathogenesis of some cases of BD.

*Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa; †Department of Medical Sciences, Section of Infectious Diseases, University of Ferrara, Ferrara; ‡Institute for Maternal and Child Health—IRCCS “Burlo Garofolo”, Trieste; and §Department of Translational Research, N.T.M.S., School of Medicine, University of Pisa, Pisa, Italy.

Send reprint requests to Fabrizio Bruschi, MD, Department of Translational Research, N.T.M.S., School of Medicine, University of Pisa, Via Roma 55, 56126 Pisa, Italy. E-mail:

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