Threat of Toxoplasmosis Targeting the Brain for Military Forces and Veterans

Context: Toxoplasmosis is one of the most common parasitic infections worldwide and is occasionally able to cause cysts in the central nervous system (CNS). Although its importance is highlighted in immune-compromised patients, it is also associated with non-identified complications due to various anatomopathological and histological changes in CNS among immune-competent hosts, particularly following travel or military deployment to endemic regions. These changes may lead to behavioral disorders, which are frequently overlooked or misdiagnosed..Evidence Acquisition: We designed a narrative review to describe the risk of toxoplasmosis associated with military jobs and the potential changes in different parts of the central nervous system during toxoplasmosis, based on published articles in the last 30 years.. The current body of evidence reveals many potential routes of transmission for military operating forces and there have been several reports of toxoplasma outbreaks among soldiers. Although acute infection is frequently symptomless, many mild and non-specific clinical manifestations are commonly overlooked. Also, military forces are prone to CNS toxoplasma infections, which may lead to several psychological and neurological clinical presentations following acute, sub-acute and chronic infection.. Toxoplasmosis is frequent among military forces and CNS infection is likely in this population. Thus clinicians must be aware and investigate toxoplasma in suspicious neuropsychological manifestations even in immunocompetent and apparently healthy hosts, particularly for military personnel deployed to endemic areas..