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At least 1,009 records · Page 56Linked to original sources
PubMed1996

Recurrent ocular toxoplasmosis in patients treated with systemic corticosteroids.

PURPOSE: The authors discuss a possible relationship between systematic corticosteroid use and reactivation of ocular toxoplasmosis. METHODS: Patients were identified who developed foci of recurrent toxoplasmic retinochoroiditis while being treated with systemic corticosteroids. Case histories were reviewed retrospectively. RESULTS: During a 10-year interval, three patients were identified at the University of California, Los Angeles, who had been receiving systemic corticosteroid therapy (dose range, 0.27-1.23 mg/kg/day) when they developed recurrent toxoplasmic retinochoroiditis. Disease occurred at intervals of 20 days to approximately 1 year after start of corticosteroid therapy. Lesions were typical in appearance, course, and manner in which they responded to antimicrobial therapy. CONCLUSION: Recurrent toxoplasmosis in patients receiving corticosteroid therapy probably is uncommon. These cases do not confirm a causal relationship between corticosteroid use and initiation of disease recurrence.

Adolescent↗
PubMed2001

Presumed acquired ocular toxoplasmosis in deer hunters.

PURPOSE: To describe acquired ocular toxoplasmosis in deer hunters. METHODS AND RESULTS: The authors describe five young men presenting with flu-like symptoms followed by visual loss due to a unilateral, focal necrotizing retinitis. All five men gave a history of ingesting undercooked or uncooked venison. All five had elevated toxoplasma serology, and all five improved clinically with an antitoxoplasma regimen. CONCLUSION: In previously healthy young men, flu-like symptoms associated with visual loss and retinitis should prompt questioning about hunting and raw game meat ingestion, especially when toxoplasmosis is suspected.

Adolescent↗
PubMed1984

Sequential disseminated tuberculosis and toxoplasmosis in a Haitian refugee.

A 27-year-old previously healthy male Haitian had sequential disseminated tuberculosis and toxoplasmosis during a three-month period. The former appeared to respond to antituberculous therapy; the latter proved fatal and was diagnosed only at autopsy. We suspect acquired immune deficiency syndrome (AIDS) as the underlying problem, which emphasizes the danger of sequential unusual infections in patients from groups with a high incidence of AIDS. This case also illustrates some of the difficulties of diagnosing toxoplasmosis and the advisability of early empiric therapy in such patients.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Fatal cerebral toxoplasmosis in a bone marrow transplant recipient with leukemia.

Although opportunistic infections after allogeneic bone marrow transplantation are common, cerebral toxoplasmosis has only been reported once. We report a case of lethal cerebral toxoplasmosis in a patient with acute leukemia who had been submitted to intensive cytotoxic therapy and allogeneic marrow rescue. The clinical course was characterized by an unusually sudden neurological onset. It was remarkable that, in this case, toxoplasma serology remained repeatedly negative. The autopsy revealed that the infection also involved the myocardium. Serological data and pathology findings are presented.

Adult↗
PubMed2004

Severe neonatal toxoplasmosis after third trimester maternal infection.

We report an unusual case of neonatal toxoplasmosis. After a late third trimester maternal infection, the infant developed severe disseminated intravascular coagulopathy with thrombocytopenia, hepatitis, jaundice and severe pneumonitis. Clinicians that manage infants with severe unexplained systemic disease should consider the possibility of congenital toxoplasmosis.

Adult↗
PubMed1989

The use of an IgM immunosorbent agglutination assay to diagnose congenital toxoplasmosis.

An IgM immunosorbent agglutination assay (ISAGA) was compared with a standard ELISA IgM test for the diagnosis of congenital toxoplasmosis. It was more sensitive, detecting all of five mothers of infected babies whereas the IgM ELISA was positive in two of three mothers tested at delivery and neither of two mothers referred 10-12 months after delivery. Five women infected in a previous pregnancy had IgM detectable by ISAGA in a subsequent pregnancy. The assays were comparable when sera from patients with past infection were tested or following toxoplasma-associated miscarriage or abortion. Four cord sera from congenitally-infected babies were positive by the ISAGA but only three of these were positive by ELISA for IgM. The ISAGA also detected IgM in another four sera from congenitally-infected babies referred late (10-18 months old); none were IgM positive by ELISA. The increased sensitivity of the ISAGA is an improvement in the diagnosis of congenital toxoplasmosis.

Agglutination Tests↗
PubMed1987

Immune response to Toxoplasma gondii--alteration of antigen specificity of peripheral blood leukocyte proliferative responses in acute toxoplasmosis.

Ultrasonicated Toxoplasma gondii (RH strain) tachyzoite extract was chromatographed on Sephadex G-200, and one main peak (93,000 M.W.) and three small peaks (greater than 160,000 M.W., 110,000 M.W., and 20,000 M.W.) were eluted. Toxoplasma-specific proliferative T cell responses of peripheral blood leukocytes (PBL) from a patient with acute toxoplasmosis caused by accidental injection of tachyzoites of the protozoa were sequentially examined by using these fractioned antigens. As early as one week after the accidental injection of the protozoa, significant proliferative responses of PBL could be detected. The reaction of proliferative T cells was observed occurring mainly with Fr. II antigen. Then T cells began to respond to Fr. I and III in addition to Fr. II 3 weeks after the injection. Thus, expansion of antigen specificity in Toxoplasma-specific T cell responses was observed at the initial stage of acquired acute toxoplasmosis.

Acute Disease↗
PubMed2004

Population pharmacokinetics of pyrimethamine and sulfadoxine in children with congenital toxoplasmosis.

AIMS: To develop a population pharmacokinetic model for pyrimethamine (PYR) and sulfadoxine (SDX) in children with congenital toxoplasmosis. METHODS: Children were treated with PYR (1.25 mg kg(-1)) and SDX (25 mg kg(-1)) (Fansidar) plus folinic acid (Lederfoline) 5 mg). Plasma concentrations, available from a therapeutic drug monitoring database, were determined by high-performance liquid chromatography. Population pharmacokinetic analysis was performed using a nonlinear mixed effects model. RESULTS: Eighty-nine children, aged 1 week to 14 years and weighing 2.9-59 kg, were available for evaluation. Both PYR and SDX concentration-time profiles were best described by a one-compartment open model. Volume of plasma distribution (V) and clearance (CL) were significantly related to body weight (BW) using an allometric function. Typical CL and V estimates (95% confidence interval), for a child weighing 11 kg were 5.50 (5.28, 5.73) l day(-1) and 36 (33, 39) l for PYR and 0.26 (0.25, 0.27) l day(-1) and 2.1 (1.9, 2.3) l for SDX. For BW between 3.5 and 60 kg, plasma half-lives were predicted to vary from 4.0 to 5.2 days for PYR, and from 5.0 to 7.5 days for SDX. CONCLUSION: This study indicated that body weight influences PYR and SDX pharmacokinetics in children. To optimize PYR/SDX combination treatment in congenital toxoplasmosis, short dosing intervals in very young low-wight children are probably appropriate.

Adolescent↗
PubMed1996

Acquired toxoplasmosis of a submandibular lymph node in a 9-year-old boy diagnosed by fine-needle aspiration cytology.

Toxoplasmosis is a parasitic infection which may be asymptomatic or produce lymphadenopathy, fever and malaise. In children the cervical lymph nodes are most commonly affected. This report describes a case of a 9-year-old boy who presented with submandibular lymphadenopathy associated with a non-vital primary tooth, which persisted following extraction of the tooth. A diagnosis of acquired toxoplasmosis was made on the findings of fine-needle aspiration cytology and subsequently confirmed by serological investigations, thus sparing the patient unnecessary hospitalization and surgery. The patient required amitryptyline as a nocturnal sedative and made a complete recovery within a few months without the need for further intervention.

Biopsy, Needle↗
PubMed1993

Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis.

Cerebral toxoplasmosis is optimally treated with the combination of high doses of sulphadiazine and pyrimethamine. We described two patients with AIDS treated for cerebral toxoplasmosis who developed renal failure due to sulphadiazine-induced crystalluria. Symptoms and renal failure were rapidly reversed with urine alkalinization and hydration. A careful monitoring and adequate hydration of patients with AIDS treated with high doses of sulphadiazine appears mandatory to avoid this complication.

AIDS-Related Opportunistic Infections↗
PubMed1987

Thymocyte-dependent immunity to toxoplasmosis in the normal and immunocompromised guinea-pig host.

Guinea-pigs made T-cell deficient by thymectomy and irradiation, and protected with syngeneic bone marrow cells (TXB) have a greatly reduced capacity to express normal cell-mediated immune functions, based on their poor responses to T-cell mitogens, prolonged acceptance of skin allografts, and susceptibility to the lethal effects of graft-versus-host disease. Further evidence for impaired T-cell activity in TXB guinea pigs was based on their inability to be fully sensitized to mycobacterial antigens, and increased susceptibility to an intradermally induced infection with the intracellular protozoan parasite, Toxoplasma gondii (RH strain). After challenge at multiple sites with 10(6) or 10(5) parasites, toxoplasmosis in thymus-intact, fully immunocompetent guinea pigs is a self-limiting and survivable infection, whereas the disease takes an acutely lethal course in the majority of TXB guinea-pigs. The latter also had more parasites disseminating to various tissues sites than their euthymic counterparts. The reduced capacity of TXB guinea-pigs to respond to mycobacterial products, and to generate anti-Toxoplasma immunity can be restored by an intravenous infusion of normal syngeneic thymocytes. These findings provide substantial direct evidence strengthening the concept that protection against toxoplasmosis is heavily dependent upon an intact T-cell component of the host's immune response.

Animals↗
PubMed2004

A case of fatal systemic toxoplasmosis in a cat being treated with cyclosporin A for feline atopy.

Acute systemic toxoplasmosis was diagnosed in a 4-5-year-old, male, Domestic Short Hair cat, which had been on cyclosporine A immunomodulatory therapy for feline atopy, over an 8-month period. Cyclosporin A (CsA) has shown promising results as a immunosuppressive agent in the cat for the treatment of eosinophilic plaque and granulomas, allergic cervico-facial pruritus, feline atopy and other immune-mediated dermatoses. However, inhibition of T-lymphocyte function by CsA is believed to have predisposed this cat to the development of a newly acquired, acute Toxoplasma gondii infection, as characterized by severe hepatic and pancreatic pathology in conjunction with the heavy parasite load demonstrated on immunohistochemical (IHC) stains for T. gondii. Cats on CsA therapy appear to be at risk of developing fatal systemic toxoplasmosis.

Animals↗
PubMed2005

Disseminated toxoplasmosis with pulmonary involvement after heart transplantation.

We report a case of pulmonary toxoplasmosis after heart transplant despite the prophylactic anti-toxoplasmic treatment that was given but was not sufficient to prevent toxoplasmosis. However, the patient survived thanks to early diagnosis confirmed by polymerase chain reaction on blood and by serological techniques, and early treatment.

Adult↗
PubMed1989

Cerebral toxoplasmosis and lymphoma in patients with acquired immunodeficiency syndrome.

16 Patients with central nervous system (CNS) complications of the acquired immunodeficiency syndrome (AIDS) are described. All patients were male homosexuals. The most common demonstrable lesion in the parenchyma was toxoplasmosis, which produced an area of focal oedema, usually containing a central zone of nodular or ring-shaped enhancement. Cerebral atrophy was also a common finding. One patient had diffuse peri-ventricular lymphomatous infiltration, and a further two patients had both cerebral toxoplasmosis and lymphoma. A delayed "double dose" contrast examination appears to be the most accurate method of outlining the total extent of CNS disease in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Haemolytic anaemia associated with acquired toxoplasmosis.

A 2 year old girl presented with fever, malaise, a maculopapular rash and lymphadenopathy followed by the onset of haemolytic anaemia and massive splenomegaly. Serology was consistent with acquired toxoplasmosis. A 6 week course of pyrimethamine resulted in a rise in the haemoglobin and reduction of the splenomegaly. During the subsequent 10 years, pyrimethamine treatment of three similar acute episodes resulted in similar clinical responses. There was no spontaneous improvement in the haemolytic anaemia or splenomegaly when pyrimethamine was initially withheld for 6, 1, and 1.5 months respectively during three of these episodes. Investigations did not reveal an immunodeficiency state. This case suggests the possibility of a previously unreported causal association between acquired toxoplasmosis and haemolytic anaemia in a child.

Anemia, Hemolytic↗
PubMed1987

Antibody patterns in the serological diagnosis of acute lymphadenopathic toxoplasmosis.

Sera from six patients at various stages of acute lymphadenopathic toxoplasmosis were tested using nine different types of test currently available for the serological diagnosis of the disease. A diagnosis was made on positive serology in three of the patients. The antibody patterns of two of these patients were studied over a period of six months and the third was studied over two months. A diagnosis was made on lymph node morphology in the other three cases. Two serum samples were tested from each of these patients. The results obtained suggest that a rationalisation of the types of test used should be encouraged and that an enzyme-linked immunosorbent assay (ELISA) for parasite-specific IgG and an antibody class capture ELISA for parasite-specific IgM are sufficient to confirm the diagnosis of acute lymphadenopathic toxoplasmosis.

Adolescent↗
PubMed2005

Reactivation of ocular toxoplasmosis during pregnancy.

We wished to assess whether ocular toxoplasmosis can be reactivated during pregnancy in immunocompetent females, and whether such reactivation is confined to the eye or whether the fetus is exposed to the risk of vertical transmission. For this purpose, we retrospectively examined 18 females with ocular toxoplasmosis during the course of 35 pregnancies. Of these 18 patients, seven developed recurrences during seven pregnancies. Due to the potential risk of functional damage to the mother and the possibility of vertical disease transmission to the fetus, we suggest following such cases carefully during pregnancy until the dimensions of the problem are more fully appreciated.

Female↗