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At least 883 records · Page 49Linked to original sources
PubMed1978

A morphologic study of opportunistic cerebral toxoplasmosis.

The morphology of toxoplasma and its interaction with the cellular elements of the brain were studied in a patient who dies of extensive cerebral toxoplasmosis superimposed on Hodgkin's disease. The cerebral lesions were devoid of inflammatory cellular response and contained numerous organisms mostly in isolated multiplying forms in neurons, glia and vascular walls. Encysted forms containing multiplying organisms were seen infrequently. Intracellular parasite was identified in normal-appearing neuropil. The mode of multiplication and cyst formation of toxoplasma appeared basically similar to that described under experimental conditions. In addition, a rapid evolution of the cerebral lesions was suggested by computerized tomography. This study suggests that tissue necrosis in human cerebral toxoplasmosis is the result of an increased rate of multiplication and enhanced cellular invasiveness of the parasite most likely related to impaired cellular immunity as has been postulated by clinical and experimental data.

Aged↗
PubMed1982

Dermatomyositis as an immunologic complication of toxoplasmosis.

We present immunohistochemical, light- and electron-microscopic findings on a muscle biopsy specimen from a 21-year-old woman who developed debilitating dermatomyosisits in the course of toxoplasmosis. The muscle showed perifascicular muscle cell atrophy and prominent ultrastructural changes consistent with polymyositis. These myopathic changes were interpreted as an immunologic complication of systemic toxoplasmosis and were related to immunohistochemically demonstrable immune complex deposits in the small blood vessels. Our data suggest that dermatomyositis is caused and/or related to Toxoplasma infection and is an immune complex-mediated systemic disease.

Adult↗
PubMed1983

Does Toxoplasma cause polymyositis? Report of a case of polymyositis associated with toxoplasmosis and a critical review of the literature.

We report here a case of polymyositis and toxoplasmosis, and review the previous examples of this association. We suggest that in most cases this relationship is due to reactivation of latent infection in an immunocompromised host. Gross immunological aberrations underline the pathogenesis of polymyositis and these predispose the patient to the development of toxoplasmosis. Anti-protozoal therapy is necessary and produces some clinical benefit, but it does not cure the polymyositis.

Adult↗
PubMed1984

Strain-dependent, route of challenge-dependent, murine susceptibility to toxoplasmosis.

The response to an intraperitoneal (i.p.) parasite challenge was compared with that caused by an oral challenge, in five different strains of mice. The results are consistent with the hypothesis that murine susceptibility to toxoplasmosis is route of challenge-dependent as well as strain-dependent. The phenomenon occurs in both sexes and appears to be a recessive trait. The finding that the susceptibility of C57BL/6j mice to oral or i.p. challenge is almost the reverse of that of LACA mice, and that BALB/c mice are resistant to challenge by either route, offers an excellent laboratory model for studies on susceptibility to toxoplasmosis.

Animals↗
PubMed1978

Immune competence in a patient with Hodgkin's disease and relapsing toxoplasmosis.

A 40 year old woman with Hodgkin's disease twice developed signs of encephalitis while being treated with prednisone and cyclophosphamide for 10 months. Since on both occasions her Toxoplasma dye test titer was 1 : 8000 or higher, she was treated on suspicion of toxoplasmosis with sulfadizine and pyrimethamine. Her tumor therapy was changed to bleomycin with lower doses of prednisone for 12 months. After death from central pontine myelinolysis, Toxoplasma and cytomegalovirus could be isolated, but no lesions attributable to these infectious agents were present. Maintenance of the patient's immune competence suggested an inquiry into the effects of the chemotherapeutic agents and of tumor infiltration for their respective interference with immunity. Using hamsters with chronic latent toxoplasmosis, it was found that both cortisone and cyclophosphamide caused recrudescence of chronic inapparent infection, that vinblastine and bleomycin interfered only slightly with the development of immunity, whereas in infiltrating lymphoma permitted immunity to develop normally. It is concluded that greater attention should be directed to the immunosuppressive effects of tumor treatment. By choice of an effective tumor therapy which is least immunosuppressive, and if necessary under cover of antimicrobial therapy, a patient with Hodgkin's disease can be aided in developing immunities which he may subsequently be able to maintain.

Adult↗
PubMed1995

Toxoplasma gondii surface antigen-1 in sera of HIV-infected patients as an indicator of reactivated toxoplasmosis.

The major surface antigen from the proliferative form of Toxoplasma gondii (P-30 of SAG-1) was chosen as a target for exploration of Toxoplasma gondii reactivation in sera from immunocompromised patients. Samples were obtained from 37 HIV-infected subjects with lymphocyte levels of CD4+ < 200/mm3. The prevalence of IgG antibodies to Toxoplasma gondii was 64.9%. Ten patients had clinical symptoms of reactivated toxoplasmosis; eight of these had Toxoplasma encephalitis. The SAG-1 epitopes were found as circulating antigen in five cases with an immunocapture enzyme immunoassay (EIA). The EIA was improved with an IgG1 monoclonal antibody to SAG-1 and a streptavidinbiotin amplification. The sensitivity, specificity and positive predictive value were 30, 92 and 60%, respectively. The SAG-1 levels were compared with different biological parameters such as HIV p24 antigen, beta 2 microglobulin, CD4+ cell count and IgG antibodies to Toxoplasma gondii. The levels of SAG-1 in these patients were significantly higher than those in the 75 healthy control persons with or without a chronic Toxoplasma gondii infection. Therefore, SAG-1 may be involved as a marker of reactivated toxoplasmosis in HIV-infected patients.

AIDS-Related Opportunistic Infections↗
PubMed1996

Classification system and case definitions of Toxoplasma gondii infection in immunocompetent pregnant women and their congenitally infected offspring. European Research Network on Congenital Toxoplasmosis.

Classification systems and case definitions provide the foundations upon which clinical and epidemiological studies are based. The European Research Network on Congenital Toxoplasmosis acknowledged the lack of such a system or definitions within its field of interest and established a working group to address the issue. Congenital Toxoplasma gondii infection was defined as occurring in four separate patient groups: pregnant women, fetuses, infants, and individuals > 1 year of age. The likelihood of Toxoplasma gondii infection was separated into five mutually exclusive categories: definite, probable, possible, unlikely, and not infected. Inclusion within a specific category is dependent upon the case definition, which is in turn derived from criteria based on serological, parasitological, and clinical information. Notes are included within the classification not only to clarify the definitions, but also to improve the reliability and quality of diagnosis. The goal is to construct a system that encompasses all aspects of congenital toxoplasmosis, which is applicable to different countries and health services, suitable for large epidemiological studies, aids the diagnosis and management of individual cases, and lends itself to computerisation.

Female↗
PubMed1994

Hemidystonia secondary to acquired toxoplasmosis in a non-immunodeficient patient.

We discuss the unusual presentation of acquired toxoplasmosis in a girl with severe and transient hemidystonia as a unique symptom. Serum titres of anti-toxoplasma antibodies increased whereas no specific antibody response in the CSF was observed. While symptomatic drugs were inefficacious, specific anti-toxoplasmosis therapy led to complete and permanent recovery within 2 months.

Cerebrovascular Disorders↗
PubMed1988

Early prenatal diagnosis of congenital toxoplasmosis using amniotic fluid samples and tissue culture.

The presence of Toxoplasma gondii in amniotic fluid was demonstrated using tissue culture in four of nine cases of congenital toxoplasmosis, whereas Toxoplasma gondii antigen was undetectable using a sensitive enzyme immunoassay technique. Parasites were identified in monolayers four days after inoculation using an indirect immunofluorescence assay. Since tissue culture may provide evidence of infection within a few days, this method is proposed for early prenatal diagnosis of congenital toxoplasmosis.

Amniotic Fluid↗
PubMed1987

Detection of circulating antigens in immunocompromised patients during reactivation of chronic toxoplasmosis.

One hundred and fifteen sera from nineteen patients undergoing bone marrow transplant and four recipients of kidney transplant who showed serological or clinical reactivation of chronic toxoplasmosis were tested for Toxoplasma gondii circulating antigen (TCA) by enzyme-linked immunosorbent assay using antitoxoplasma IgG antibody coupled to alkaline phosphatase. Seven bone marrow transplant patients and one kidney transplant recipient were TCA positive either before or at the time of antitoxoplasma IgG antibody increase. TCA continued to be detected in one patient with neurological toxoplasmosis until his death. In the other patients, TCA disappeared when IgG antibodies rose, probably due to the formation of immunocomplexes consisting of TCA and immunoglobulins. In the TCA seronegative patients, the presence of circulating immunocomplexes or TCA kinetics of short duration may explain these results. Patients receiving immunosuppressive therapy should be tested for TCA.

Antigens, Protozoan↗
PubMed1992

Comparison of two medications in central nervous system toxoplasmosis in patients with AIDS.

We retrospectively examined 39 patients with AIDS and central nervous system toxoplasmosis in order to determine the efficacy and safety of two combinations: pyrimethamine-sulfadiazine and pyrimethamine-clindamycin. The results showed a response rate of 79% for the sulfadiazine association and a high failure rate in the clindamycin group. Side effects with sulfadiazine were slightly more frequent, but with desensitization protocols discontinuation was kept down. The combination of pyrimethamine and sulfadiazine, associated, when necessary, with desensitization schedules, was confirmed to be first choice therapy for cerebral toxoplasmosis in AIDS patients. The role of alternative regimens needs further evaluation.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Recent developments in the prevention and treatment of congenital toxoplasmosis.

The manifestations of congenital toxoplasmosis vary considerably in degree, characteristics and time of onset. Options for prevention of the disease include the appropriate disposal of cat litter and the avoidance of ingestion of both contaminated food and undercooked meat by pregnant women. Immunisation of the domestic cat population is a consideration for the future. Alternatively, immunisation of sero-negative pregnant women awaits the introduction of an effective and safe reagent. Current treatment modalities are not universally effective and new drugs are the subject of active development and research. Screening of pregnant women or perhaps newborn infants are potential options but the cost effectivity has yet to be established in many countries and the results of treatment during pregnancy and early childhood are encouraging but are as yet unproven. The majority of patients with congenital toxoplasmosis eventually develop toxoplasmic retinochoroiditis. Current treatment options for this condition are outlined. Acquired immune deficiency syndrome (AIDS) may, in some cases, represent a recrudescence of congenital intracerebral infection. Current treatment strategies for this condition are discussed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Toxoplasmosis in women of child bearing age and infant follow up after in-utero treatment.

A total of 540 women (including 70 pregnant cases) of child bearing age with bad obstetrical history were tested serologically for anti-toxoplasma antibody using microlatex agglutination test. Forty two women including 5 cases of pregnancy were found to be seropositive in a titre of 1:32 or more. Maximum prevalence (10.2%) and highest titer of anti-toxoplasma antibodies were observed in women of 35-42 years age group. The overall prevalence of toxoplasmosis in these women was 7.7%, whereas it was 7.1% in pregnant women. Further studies are needed to estimate the exact rate of prevalence of infection. Of the 70 pregnant women, 5 were seropositive and two of them acquired infection during pregnancy which was detected by IgM immunosorbent assay. Seropositive pregnant women were treated using combined regimen of sulfadiazine and pyrimethamine. Four infected women with pregnancy were followed up and one did not turn up subsequently. There was spontaneous abortion in one case and in 3 other cases full term normal babies were delivered. Incidence of toxoplasmosis in women is low because of infrequent and uncommon practices of ingesting undercooked or uncooked food stuff specially meat by a substantial number of the population surveyed.

Adolescent↗
PubMed2006

Globe calcification in congenital toxoplasmosis.

Various patterns of distribution of intracerebral calcification have been described in congenital toxoplasmosis. We report a case of congenital toxoplasmosis with a rare finding of calcification in the globe detected by CT scan that has not been described earlier.

Brain Diseases↗
PubMed2004

[Prevalence and public-health-aspects of toxoplasmosis].

Toxoplasmosis is one of the most common infectious diseases of man, which usually is not dangerous. Infection results from ingestion of cyst-containing meat products or by contact with oocyst-contaminated soil. Clinically relevant are (1) reactivation of latent infection in immunocompromised individuals or (2) primary infection during pregnancy with subsequent prenatal toxoplasmosis of the fetus. In Germany, law requires the prenatal infection to be reported to the Robert Koch-Institute. Since most Toxoplasma-infected children are asymptomatic at birth and later develop sequelae (retinochoroiditis) up to the age of 20 years, no valid epidemiological data are currently available for Germany. However, some studies indicate that seroprevalence correlates with age and that 26-54% of women of childbearing age have antibodies against Toxoplasma gondii; incidence rates during pregnancy have been calculated to be between 0.5 and 0.6%. Knowing the life cycle of Toxoplasma gondii will help to maintain preventive measures for seronegative pregnant women, children, and immunocompromised individuals.

Communicable Disease Control↗
PubMed2002

[HIV-associated cerebral toxoplasmosis -- review and retrospective analysis of 36 patients].

Highly active antiretroviral therapy (HAART) has resulted in a reduction of morbidity and mortality in HIV-associated cerebral opportunistic infection. Before HAART, up to 50% of all HIV-infected patients in Europe developed cerebral toxoplasmosis, an encephalitis caused by reactivation of Toxoplasma gondii infection. Although potent therapeutical options exist, the prognosis is still poor. We describe the course of 36 AIDS patients with cerebral toxoplasmosis and present a review of clinical signs, diagnosis, therapy, and survival times. The main criteria for differential diagnosis from other secondary neuromanifestations such as primary CNS lymphoma, progressive multifocal leukencephalopathy, abscesses, and ischemic infarctions are described. Indications and problems of stereotactic biopsy are discussed.

AIDS-Related Opportunistic Infections↗
PubMed2000

MRI of intracranial toxoplasmosis after bone marrow transplantation.

Toxoplasma encephalitis was confirmed by biopsy in three patients with bone marrow (BMT) or peripheral blood stem-cell transplantation (PBSCT). All had MRI before antimicrobial therapy. The intensity of contrast enhancement was very variable. One patient had one large, moderately enhancing cerebral lesion and several smaller almost nonenhancing lesions. The second had small nodular and haemorrhagic lesions without any enhancement. The third had late cerebral toxoplasmosis and showed multiple lesions with marked contrast enhancement. The moderate or absent contrast enhancement in the two patients in the early phase of cerebral toxoplasmosis may be related to a poor immunological response, with a low white blood cell count in at least one patient. Both received higher doses of prednisone than the patient with late infection, leading to a reduced inflammatory response. In patients with a low leukocyte count and/or high doses of immunosuppressive therapy, typical contrast enhancement may be absent.

Adult↗
PubMed2006

Optic nerve toxoplasmosis and orbital inflammation as initial presentation of AIDS.

PURPOSE: To report a case of toxoplasmosis with optic nerve and orbital involvement as the initial presentation of HIV infection. METHOD: Case report. RESULTS: A 46-year-old zookeeper, who had had right central retinal vein occlusion (CRVO) 2 weeks previously, presented with painless lid and conjunctival swelling and profound visual loss in his right eye (RE). Examination revealed no light perception (NLP) RE with axial proptosis and ocular motility restriction; fundal examination revealed a clinical picture of an ischaemic CRVO. MRI of the brain and orbit showed ring-enhancing targetoid lesions in the brain and inflammatory changes in the right optic nerve, extraocular muscles and orbital fat. He was subsequently found to be HIV positive and had positive toxoplasma IgG serology. CONCLUSIONS: Immunocompromised individuals have an increased likelihood for more severe and atypical presentations; this highlights the need for increased index of suspicion for HIV infection as ocular or orbital disease may be the first manifestation of life-threatening systemic toxoplasmosis.

AIDS-Related Opportunistic Infections↗