Dr. med. Uwe Auf der Strasse

Case 1

                                                                                                      (taken from chapter 14;  18 more case reports in the book)

 

Remark: until 2/2021  we have collected about 90 case reports, in which a chronic active toxoplasmosis could be confirmed by a positive LTT and a successful therapy could be performed. The case report presented here was taken from the book "Shadow disease chronic active Toxoplasmosis"  and shows a positive Toxoplasma LTT and a "revolving therapy", which sidetracks adaptive abilities of Toxoplasma  and restores the efficiency of the therapy. 

 

Ms. Sabine S. age 50 years, was suffering from depression and tiredness of unknown origin for some years. In 4/2016, a close friend of her's passed away, which affected her seriously, and her health detoriated more and more. Tiredness increased, and profuse sweating set in, as well as muscular pains, exertional dispnoea, listlessness, and a concentration disorder developed. The whole disease had worsened gradually during the last three years.

In May 2019 we had a consultation and the checklist revealed a high risk for a chronic active toxoplasmosis.  Lab results: Toxoplasma IgG 64,8 IU/ml, IgM 6,06 AU/ml, Toxoplasma LTT 23,0 SI (positiv above 3).

 

Due to the typical combination of symptoms and significant positive Toxoplasma LTT a combi-nation therapy, consisting of clindamycine 3 x 300 mg, daraprim 2 x 25 mg and Calciumfolate 6,35 mg 1 x 1, was prescribed. This resulted in a good amelioration of symptoms, but the effiacy of this treatment decreased after 10 days, and the symptoms increased again. This has happened in other cases as well, and I developed a Revolving Therapy concept, which proofed to be highly effective in these cases - this is one of the possible combinations I prescribe in many cases: 

 

-  Pyrimethamine 25 mg 2 x 1 and Calciumfolinate 6,35 mg 1 x 1 were taken continuously.

   An antiobiotic was added, at first 

 

-  Cotrimoxazole 960 mg  2 x 1,  after 5 days this was changed to 

 

-  Clarithromycine 500 mg 2 x 1, after 5 days this was changed to

 

-  Clindamycine 300 mg 3 x 1, after 5 days this was switched back to

 

-  Cotrimoxazole 960 mg 2 x 1 again, and the whole system was repeated.

 

   This revolving therapy resulted in a continuous improvement of all symptoms. 

           

            Checklist 

            Toxoplasmosis        Mr / Mrs.   Sabine S. 

                                                                                                                 Fluctuation of

            Age: …50...Years             Duration:     3 years            symptoms yes / No

 

                     Toxoplasma                        IgG 64,8 IU/ml                          IgM  6,1 AU/ml

 

                 LTT 23,0 SI                         Date......…......21.5.2019              Date.............16.7.2019  

                 

                 Treatment:                         Clindamycin 3x300mg             Revolving Therapy 

                                            

                 Tiredness                            0 1 2 3 4 5 6 7  X 9 10              0 1 X 3 4 5 6 7 8 9 10

               

                 Muscular pain                    0 1 2 3 X 5 6 7 8  9 10              X 2 3 4 5 6 7 8 9 10

               

                 Concentration -                  0 1 2 3 4 5 6 X 8  9 10              0 1 X 3 4 5 6 7 8 9 10

                 disorder

                 

                 Profuse sweating              0 1 2 3 4 5 6 7  8 X 10              0 1 X 3 4 5 6 7 8 9 10

                 

                 Shortness of breath          0 1 2 3 4 5  X 7 8 9 10              0 1 X 3 4 5 6 7 8 9 10

 

                 Listlessness /                    0 1 2 3 4 5  6 7 8 9  X               0 1 2 3 X 5 6 7 8 9 10

                 Exhaustion...............................................................................................................................

                 Irritability                            0 1 X 3 4 5 6 7 8 9 10              0 X 2 3 4 5 6 7 8 9 10

               

                 Visual disturbancy             0 1 2 3  X 5 6 7 8 9 10              0 1 X 3 4 5 6 7 8 9 10

               

                 Dizzyness                           0  X 2 3 4 5 6 7 8 9 10              X 1 2 3 4 5 6 7 8 9 10

               

                 Depressive moods             0 1 2 3  4 5 6 7 8 X 10             0 1 2  X 4 5 6 7 8 9 10 

               

                 Anxieties                             0 1 2 3  X 5 6 7 8 9 10              0 1 X  3 4 5 6 7 8 9 10

                 Morning stiffnness             0 1 2 3  X 5 6 7 8 9 10              0 X 2 3 4 5 6 7 8 9 10

                 Oedema                               0 1 2 3 X 5 6 7 8 9 10              0  X 2 3 4 5 6 7 8 9 10

                 Sleeping disorder               0 1 2 3 4 5 6 7 8 9   X              0 1 X 4 5 6 7 8 9 10

                 Insecure gait                       0 1 2 X 4 5 6 7 8 9 10              0 2  3 4 5 6 7 8 9 10

                 impaired coordination..........................................................................................................

                 Pressure in upper              0 1 2 3  X 5 6 7 8 9 10             0  2 3 4 5 6 7 8 9 10

                 abdomen

                 

                 Headache                            0 1 2 X 4 5 6 7 8 9 10              X 1 2 3 4 5 6 7 8 9 10

                 Joint pains                          0 1 2 3 X 5 6 7 8 9 10              1 2 3 4 5 6 7 8 9 10

                 Swollen lymphnodes         X 1 2 3 4 5 6 7 8 9 10              1 2 3 4 5 6 7 8 9 10

                 

                 SCORE                           96                                      27

 

Comment: Ms. S. had been ill from a chronic active Toxoplasmosis for only 3 years, and as in other cases with a short duration of disease, most symptoms in the lower part of the checklist are not very pronounced. The Toxoplasma IgG is significant positive at 64,8 IU/ml and indicates that the person is a Toxoplasma carrier. The Toxoplasma IgM is, at 6,06 AU/ml, not significantly increased. 

 

In a traditional practice these results would mean, that a toxoplasmosis treatment would not be prescribed. On a closer look, a negative IgM merely shows, that there is presently no significant activity of tachzoites. It doesn't tell us anything about bradyzoite activity, which can cause significant symptoms on its own (42). 

 

The positive Toxoplasma LTT of 23,0 SI indicates, that there is a toxoplasma activity, but as the tachyzoite-specific IgM is not significantly increseased, this activity is most likely caused by bradyzoites. 

 

Together with the result of the checklist, the significantly positive Toxoplasma LTT overruled the result of the antibody assays and justified prescribing a combination therapy from the beginning on. This resulted in a good amelioration of symptoms. When the effect of this therapy decreased after 10 days, the significant toxoplasma LTT result backed the decision for a Revolving Therapy, which finally led to a very good remission of all symptoms.