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PubMed1992

[Opportunistic toxoplasmosis in a case of heart transplantation].

Infection with toxoplasma gondii is a serious complication in the immunocompromised heart transplant recipient. We reported a case of toxoplasmosis in a seronegative heart transplant recipient detected on endomyocardial biopsy. This patient was treated with oral pyrimethamine and sulphadiazine. Because primary toxoplasmosis occurred in seronegative patients receiving hearts from sero-positive donors, it is necessary to screen both recipients and donors for T. gondii. Prophylaxis with pyrimethamine in sero-negative patients transplanted with a heart from sero-positive donors confers considerable benefit.

Adult↗
PubMedDate not supplied

[The seroprevalence of human toxoplasmosis in Córdoba].

A seroprevalency study of human toxoplasmosis was carried out in Córdoba, using indirect immunofluorescence and indirect hemagglutination. The sample of people interviewed was made up of 443 serums, 356 supposedly healthy people (mainly students) and 87, considered "high risk" (patients from the "Reina Sofia" Hospital). The positiveness obtained for the total of the sample was 43.79% with IFI and 53.59% for HAI. As regards sex of the person tested, prevalence is higher in women, with 54.36% and 70.47% with IFI and HAI respectively, in men the scores were 38.43% and 44.90% for the same tests. As far as the origin of the sample was concerned, there were 31.18% with IFI and 43.25% for HAI of the normal population, in the "high risk" sample, for both tests it was 95.40%. With both tests there are significative differences in low amounts, but not in high dilutions. We conclude that human toxoplasmosis is present and widespread in the studied population.

Animals↗
PubMed1992

Toxoplasma pneumonitis: fatal presentation of disseminated toxoplasmosis in a patient with AIDS.

Toxoplasma gondii infection is an uncommon cause of pneumonitis in patients with acquired immune deficiency syndrome (AIDS). We report a case of fatal pulmonary toxoplasmosis, which clinically resembled Pneumocystis carinii pneumonia (PCP). Conventional diagnostic methods for toxoplasmosis lack sensitivity. Bronchoscopy and histological evaluation of transbronchial biopsy specimens failed to identify the infecting organism. At autopsy there was evidence of disseminated infection.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Pancytopenia as a complication of the treatment of toxoplasmosis].

Therapeutical doses of pyrimethamine are very close to toxic ones. Pyrimethamine is widely used in toxoplasmosis therapy. Hematological complications following pyrimethamine administration were seen in 4 patients treated for toxoplasmosis at our hospital in the last year. Pancytopenic syndrome was diagnosed in all four cases. Three patients recovered completely whereas ITP is persisting in one patient.

Adult↗
PubMedDate not supplied

[Observations of children with chorioretinitis in congenital toxoplasmosis].

Hundred eleven children with congenital toxoplasmosis were followed up in the Department of Infectious and Parasitic Diseases in Childhood, Medical Academy in Warsaw, within 1979-1988. Ocular changes found in 91 children including chorioretinitis in 86 microphthalmia in 7, ophthalmic nerve atrophy in 15, vitreous body inflammation in 5, and cataract in 4. Only in 16 children the diagnosis was performed in the first year of life. In 15 children the recurrence of inflammatory process, most frequently in the time of puberty, was noted; twice in 5 of them. It was independent on the treatment which was previously administrated. Serological tests in ocular form of congenital toxoplasmosis do not indicate the dynamic changes in the inflammatory process. It is very important that small children are examined early and the treatment is started in the first year of life.

Adolescent↗
PubMed2004

Ocular toxoplasmosis: a global reassessment. Part II: disease manifestations and management.

PURPOSE: To update clinical information about ocular toxoplasmosis. Part II reviews the spectrum of disease manifestations and factors that influence severity of disease. Implications for disease management are discussed. DESIGN: Literature review. METHODS: Selected articles from the medical literature, information from several recent scientific meetings, and the author's personal experiences were reviewed critically in preparation for the LX Edward Jackson Memorial Lecture. RESULTS: The appearance of toxoplasmic retinochoroiditis lesions varies with duration of active retinal infection and intensity of inflammation. Severe ocular disease occurs in immunocompromised hosts. Older patients who are recently infected with Toxoplasma gondii may have a higher prevalence of ocular involvement and more severe ocular disease because of altered host defenses. Most disease-producing isolates of T. gondii belong to one of three clonal lineages (types I, II, III); type I has been associated with severe disease in both animals and human beings. Many observational studies suggest a benefit of short-term antimicrobial therapy for toxoplasmic retinochoroiditis in immunocompetent patients, although the efficacy of these treatments has not been proven in randomized clinical trials. Intermittent trimethoprim/sulfamethoxazole treatment was associated with fewer recurrences than placebo during a 20-month randomized clinical trial. CONCLUSIONS: Variations in disease characteristics may be related to host, parasite, or environmental factors. The genotype of the infecting parasite appears to be an important determinant of disease severity in immunocompetent patients. Secondary prophylaxis may reduce the rate of recurrences in high-risk patients. A better clinical understanding of ocular toxoplasmosis can lead to more effective prevention and treatment strategies.

Adult↗
PubMed2004

[Follow up of 16 cases with congenital toxoplasmosis treated with azithromycin].

OBJECTIVE: To study the therapeutic effects of azithromycin in treatment of congenital toxoplasmosis in children. METHODS: Definite diagnosis of congenital toxoplasmosis was made on the basis of clinical manifestation combined with one or more positive results of the following laboratory tests and excluded other congenital infectious diseases: toxoplasma DNA (TOX-DNA), circulating toxoplasma antigen (TOX-CAG), and toxoplasma IgM antibody (TOX-IgM). All the patients were given oral azithromycin 10 mg/(kg.d) for 6 days followed by 8 days without medication (one course of treatment), and the regimen was persisted for 2 months and then another 2-month treatment was given at a 1-month interval. The authors continued to provide further treatment according to the state of the illness at one month interval. The patients received 2 to 8 (average 5) courses of treatment. The patients were followed-up for 2.5 to 5 (average 4) years. RESULTS: The treatment was effective in all the patients and the patient's condition was improved. The authors repeated in 12 cases the four tests for toxoplasma (TOX-DNA, TOX-CAG, TOX-IgM, and TOX-IgG) 9 months to one and a half years after treatment. In 10 cases all these tests showed negative results, in 2 cases TOX-IgG was positive and in the other 4 cases symptoms disappeared. CONCLUSION: The results of the study showed that oral azithromycin had significant therapeutic effects with little side effect and was well tolerated. Azithromycin may become an alternative therapy in treatment of congenital Toxoplasma gondii infection in children.

Anti-Bacterial Agents↗
PubMed1992

Tonsilar toxoplasmosis.

One hundred cases were suffering from chronic tonsillitis, aged between 4-12 years, of both sexes (60 males and 40 females), from outpatient clinic of E.N.T. unit at Benha Faculty of Medicine. They were examined serologically by indirect haemagglutination--antibody technique (IHAT) for toxoplasmosis. After tonsillectomy, histopathological and electronmicroscopical studies were done. Ten percent of cases were positive serologically, among males (11.71%) and females (7.5%). The positivity rate was high among age group 10-12 years than others. Two cases showed histopathological and ultrastructural changes indicating toxoplasmosis.

Animals↗
PubMedDate not supplied

[Use of a helminthic indicator of soil to determine the frequency of toxoplasmosis among pregnant women].

Studies have ascertained the high dissemination of the soil with helminthic eggs and cysts of intestinal pathogenic protozoa (Lamblia, Toxoplasma, etc.) in some districts of the Belgorod Region. Comparing these data with the morbidity rates in pregnant females with toxoplasmosis shows a direct high correlation of the above indicators. The latter makes it possible to recommend the helminthic indicators of soil contamination to be used to determine the rate of toxoplasmosis in pregnant females.

Animals↗
PubMed2004

Review on human toxoplasmosis in Malaysia: the past, present and prospective future.

We reviewed various studies regarding human toxoplasmosis in Malaysia. They showed a varying prevalence of specific Toxoplasma antibodies among the Malaysian population. The Malays have shown the highest seroprevalence of toxoplasmosis, by most studies, when compared to other races. Demographic profiles have shown that Toxoplasma seropositivity is higher in males than females, lower in people with higher incomes, higher in the unemployed and tends to increase with age. In general, the route of transmission, such as contact with a cat, consumption of undercooked meat and blood transfusion were shown to have no significant association with Toxoplasma seropositivity (p > 0.05). The immune status (CD4 cell count < 200 cell/mm3) was strongly associated with toxoplasmic encephalitis (p < 0.05).

Adolescent↗
PubMed2004

Evaluation of semi-quantitative PCR and IgG & IgM ELISA in diagnosis of toxoplasmosis in females with miscarriage.

One hundred female (age 20-42 yrs) patients were classified into group I: 40 patients presented with abortion in the first trimester; group II: 33 patients with abortion in the second trimester and group III: 27 patients with intrauterine fetal death (IUFD). The positive percentages of semi-quantitative PCR and both IgG & IgM ELISA were 38% and 35% respectively. Ten (26.3%) cases out of 38 were positive for toxoplasmosis by both PCR and ELISA-IgG, while 5 (13.2%) cases out of 38 were positive by both PCR and ELISA-IgM, whereas 16 (42.1%) cases out of 38 PCR positive cases were positive by both ELISA IgG & IgM. Sensitivity and specificity of both ELISA IgG and IgM were 81.57% & 93.54% respectively. False negative by ELISA were found in 7 cases out of 38 positive toxoplasmosis cases detected by semi-quantitative PCR. Three cases out of the 7 cases with false negative by ELISA were detected with a trophozoite copy load of 10(1) trophozoite /mL in the blood sample by semi-quantitative PCR. So, the semi-quantitative PCR detected low levels of parasite DNA recommending its usefulness especially in the early stages of the disease when low amount of antibodies can't be detected by serological method or even by the conventional PCR.

Abortion, Spontaneous↗
PubMed1992

[Cerebral toxoplasmosis primarily diagnosed as a tumor].

Three cases of cerebral toxoplasmosis as the presenting manifestation of AIDS are reported. The initial diagnoses were brain tumors because of the cerebral mass lesions which resembled glioblastoma. In the light of the increasing occurrence of AIDS, attention is drawn to cerebral toxoplasmosis as a differential diagnosis from glioblastoma multiforme.

Brain Neoplasms↗
PubMed1992

Immunoglobulins and serum proteins in toxoplasmosis.

Immunoglobulin levels in 47 children (age 13-20 years) with toxoplasmosis were compared with 46 age and sex matched controls. No significant difference was observed in mean serum immunoglobulin (IgG, IgA, IgM) levels between patients and controls but mean IgM levels were significantly (P) higher in children with acute toxoplasma infection. Total proteins were higher in patients while mean albumin and globulin levels were similar between the two groups. Estimation of serum immunoglobulins in young children with toxoplasmosis has no significance and should not be considered as an immunodiagnostic tool.

Adolescent↗
PubMed1992

Leukaemogenic effect of toxoplasmosis and irradiation on albino rats.

The leukaemogenic effect of irradiation associated with toxoplasmosis was studied. Rats were infected with Toxoplasma gondii RH strain 3 weeks prior to irradiation. The leukaemic effect of irradiation was aggravated by toxoplasmosis as leukaemia appeared in 10% of 300 cGy irradiated rats and in 30% of 500 cGy irradiated ones, six months after irradiation.

Animals↗
PubMed1992

[Significance of the complement fixation reaction in the diagnosis of the acute phase of lymphatic toxoplasmosis].

In a group of 300 sera of subjects with clinically suspect nodular toxoplasmosis the authors tested by the IgM ELISA reaction in the reverse order the importance of the complement-fixation reaction for assessment of the acute stage of the infection. In view of the revealed prolonged detection of IgM antibodies the authors used quantitative evaluation of the reaction; they consider based on a probability pattern of antibody response coefficients of 10 and above important for differentiation of a recent infection. For the suggested method of evaluation it was confirmed that low CFR titres (1:8, 1:16, 1:32) imply usually (89.5%) latent infection, titres of 1:64 chronic (42.8%) and latent infection (57.2%); in no instance onset of the disease was involved. From the titre of 1:128 onwards there is a proportional increase of the probable detection of acute infections (titre 1:1024 as much as 72.7%. However, even high titres are not unequivocal evidence of recent infection. In view of the equivocal interpretation of results of the CFR the authors recommend for assessment of the acute stage of the nodular form of toxoplasmosis examination of the suspect subject by the CFR and in case of a medium or high level assessment of IgM by the ELISA method focused on the level and dynamics of the coefficient.

Acute Disease↗
PubMed1992

Blindness associated with toxoplasmosis in canaries.

Seven of 30 canaries in an aviary in New Zealand developed ophthalmic problems. Clinically, 5 birds had unilateral and 2 birds had bilateral lesions characterized by conjunctivitis, crusty exudates on eyelids, and collapse of the eyeball. Microscopic lesions in 12 of 14 eyes examined included inflammation of the choroid and retina, with osseous replacement of the globe in some. Numerous Toxoplasma gondii tachyzoites were seen in the detached retina and vitreous humor of acutely affected birds. The diagnosis of toxoplasmosis was confirmed by immunohistochemical staining with T gondii antiserum. Affected birds had encephalitis, and T gondii was localized in the brains of these by immunohistochemical examination and by use of bioassays in mice. Toxoplasmosis should be considered in differential diagnosis of ophthalmitis in canaries.

Animals↗
PubMed1992

[Value of different serological tests in the diagnosis of various forms of active ocular toxoplasmosis].

The analysis of results of indirect immunofluorescence and direct agglutination reaction in patients with various forms of ocular toxoplasmosis showed that these reactions have a limited value in diagnostics of this condition. One can define a sure diagnosis of active ocular toxoplasmosis when the titre of these reactions are higher than 512. The ELISA IgM reaction is specific for the active form of this disease. The sensitivity of this reaction amounts 43-50%. In cases of iridocyclitis the results of the serological tests were similar to those of the control group; this confirms the hypothesis that the inflammation is evoked by an allergic reaction.

Adult↗
PubMed2005

Co-existance of toxoplasmosis and neuroborreliosis - a case report.

The 53-year-old woman was initially diagnosed with multiple sclerosis, despite the fact that she did not really meet the clinical criteria. Her only symptoms were clumsiness and weakness of the right extremities. Being a veterinary research worker she had been exposed to infectious material. In 1995, she was diagnosed with ELISA as having toxoplasmosis and treated as such. In 2002, after the infectious, flu-like disease, she revealed arthritis and drowsiness, also with memory and language impairment. The patient continued to have symptoms consistent with previously examined clumsiness. She was diagnosed with Lyme via ELISA and PCR, and treated. She made a full recovery from acute symptoms. After a few months, neurological and neuropsychological examinations were performed. On the background of mild cognitive decline apraxia and difficulties of attention were noted as the main problems. A apraxia of the right hand complicated the patient's life and depreciated her quality of life. The patient underwent MRI examination. FSE, FAST and FLAIR sequences were made. The MRI demonstrated the appearance of several small hyperintense lesions in the white matter of the left and right frontal and left parietal lobe. These lesions were typical of the post-inflammatory leucoencephalopathy. Additionally, a ring-shaped, low-intensity lesion in the posterior part of the left parietal lobe was noticed. The lesion was 8 mm in diameter and described to be an old toxoplasmosis lesion. The patient had been treated and the symptoms consistent with Lyme disease resolved. Patient continues to have symptoms consistent with focal destruction of the parietal lobe. Over the past six months, she has not progressed and relapsed in a manner that is consistent with MS.

Diagnosis, Differential↗