Case 4

Dr. med. Uwe Auf der Strasse

Ms. Dagmar U., 34 years                                     Under "Media" you will find an interview with Ms. U., unfortunately                                                                                                                                                              a translation is not available yet

 

Ms. U. is a medical assistant and works in palliative medicine; due to her good health, she has visited the practice only occasionally in the recent years. A thyroid inflammation was diagnosed in 2010 and has been treated accordingly since then, there are minor problems with the lumbar spine.

 

In the begin of January 2021, Ms. U. was infected with Covid-19, PCR testing showed a positive result. The CT value was 20.69 and thus indicated a clear infectiousness. The course over 5 weeks roughly corresponded to a pronounced flu-like infection, but a considerable reduction in performance, concentration disorder, shortness of breath even with light exertion and considerable pain in the entire musculature persisted even after the acute phase, the musculature and the connective tissue were even already painful with light touch. 

 

The laboratory values ​​were normal, because of the shortness of breath a cardiological exa-mination was arranged in February 2021, showing normal results. An X-ray tomography of the thorax also showed an inconspicuous result, there was no evidence of damage caused to the lung by the Covid-19 infection.

 

During the anamnesis, it was now apparent that Ms. U. had previously experienced similar symptoms and unclear reduced performance, but never as intense as after the Covid disease. She reported that she always kept cats until 2 years ago, she also likes to eat meat and often does. The Toxoplasma IgG with 69.6 IU / ml indicated that Ms. U. is a Toxoplasma carrier.

 

The Toxoplasma IgM showed a negative result, which excluded acute toxoplasmosis. However, it is important to note that a reactivation of toxoplasmosis can only be detected by IgM assays if toxoplasma become active to a point that they change from the cyst form, the bradyzoites, back to the "fast" form, the tachyzoites.   Unfortunately,  it is widely nor  recognised  that, according  to  the findings of basic research, such a reversal is not a prerequisite for the development of symptoms of the disease (42). So if an increased toxoplasma activity in the cysts causes a chronically active form of toxoplasmosis, this cannot be detected by  using  antibody assays.

 

With a score of 73, the toxoplasmosis checklist indicated a clear risk of chronic active Toxo-plasmosis. The Toxoplasma LTT yielded a clearly positive result at 28.0 SI.  Some of the  symptoms in the lower part of the questionnaire are inconspicuous,  this is typical if the duration of the illness has only been short; if a treatment is not performed, these symptoms would most likely increase during the next months and years. A revolving therapy was prescribed, using the same scheme as in case 1, as this is well tolerated and works very reliably.

Checklist

Toxoplasmosis        Ms. / Mr. Dagmar U.

                                                                                               Fluctuation of

Age: ... 34 ... years            Duration 2 months                   symptoms    yes / no

 

Toxoplasma                         IgG 69.6 IU / ml                      IgM 0 AU / ml

 

LTT 28.0 SI                          Date ... 25.2.2021                   Date .... 28.4.2021

                 

Treatment:                  revolving therapy               revolving therapy

                                            

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

               

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

               

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

-disorder

                 

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

                 

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

 

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

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

 

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

               

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

               

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

               

Depression                                X 1 2 3 4 5 6 7 8 9 10             X 1 2 3 4 5 6 7 8 9 10

               

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

 

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

 

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

 

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

 

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

impaire coordination ..........................................................................................................

 

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

 

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

 

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

 

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

    

SCORE                                 73                                              29

Comment:  Constant activity of our immune system is required to keep Toxoplasma in check so that they do not cause symptoms (6, 35, 78, 79). This control is ensured by CD4 T-helper cells and CD8 cells  but these can severely be impaired by a Covid-19 infection. Please read the “Update December 2020”, which describes this in detail.

 

It can be concluded that the Covid-19 infection had probably weakened the immune system to a point, that a previously reduced  Toxoplasma activity increased significantly and prevented Ms. U. from recovering. So far, I know of 4 cases with such a course of  disease, confirmed by LTT testing, who could be treated successfully by prescribing a toxoplasmosis treatment, as in the case described here.

 

Worldwide, 30-60% of the people are carriers of toxoplasmosis, in Germany and France the infestation is at least  50% (59, 63). The result is that between 30 and 60% of the people who become infected with Covid-19 are also carriers of Toxoplasma, which can potentially enter a more active stage when a Covid-19 induced weakening of the immune system takes place. In summary, in a considerable number of those affected, a Covid-19 infection could be followed by a reactivation of Toxoplasmosis. This course of the disease is difficult to differentiate from Long-Covid and cannot be ruled out by the usual antibody assays, but it can be confirmed by LTT testing and treated successfully once it has been diagnosed.