[Acute ocular toxoplasmosis--case report].
The authors a case with uveoretinal toxoplasmosis, in a immunocompetent patient. There are some discussions about treatment and evolution in such cases.
Acute Disease↗
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[Ocular toxoplasmosis and consecutive complicated cataract].
The paper reports three clinical cases which have in common two elements: ocular toxoplasmosis and consecutive complicative cataract, the method of treatment, the evolution and the recovery visual acuity.
Adult↗
Case from the aerospace medicine residents' teaching file. Chorioretinitis due to toxoplasmosis.
An aviator presented with visual changes which proved to be chorioretinitis due to toxoplasmosis. The evaluation, treatment, and aeromedical disposition of this pilot are discussed.
Aerospace Medicine↗
[Treatment difficulties in ocular toxoplasmosis].
PURPOSE: To determine the increased incidence of ocular infection with Toxoplasma gondii, the variety of ocular manifestations and therapeutical problems of this potential blind disease. We analyzed 22 patients hospitalized in our clinic in last 2 years at whom clinical diagnosis was confirmed by positive serological tests. Is discussed the correlation between serum level antibody(IgG and IgM) and ocular manifestations and the opportunity of beginning specific treatment depend on these two parameters. CONCLUSIONS: The incidence of ocular toxoplasmosis is increasingly, the ophthalmologist must be open on atypical manifestations of this disease. The treatment remains controversial, we believe that it must be specific and correlated with ocular lesions evolutions and serum antibody level in time.
Adrenal Cortex Hormones↗
[Toxoplasmosis in Gabon. Results of a seroepidemiological investigation].
A toxoplasmosis sero-epidemiological inquiry was effected with 2,324 sera collected from Libreville, Lébamba, Makokou, Lastourville and Woleu-Ntem. All the sera were first screened through Pastorex toxo (Diagnostics Pasteur). Those with more 8 IU/ml and 267 sera with less 8 IU/ml were then assayed by ISAGA (bioMerieux) for IgM. The results of ISAGA must be interpreted with carefulness for natural agglutinins are frequent in this population. The acquisition of immunity is precoce and more of 60% have a serology positive from ten years old. There was no difference between sex.
Adolescent↗
[Effect of corticosteroids on the congenital transmission of experimental toxoplasmosis].
Female white mice with chronic toxoplasmosis were treated with cortisone acetate (3mg for each 25 g of body weight) 12, 8, 4 and 0 days before mating. Cortisone induces congenital transmission of T. gondii.
Animals↗
[Hemichorea-hemiballismus and toxoplasmosis in AIDS].
The authors report two cases of hemichorea-hemiballism revealing a toxoplasmic abscess in the subthalamic nucleus during AIDS. Despite the great frequency of this opportunistic infection such cases are exceptional. This rarity seems to be explained by the frequent association of other lesions of the basal ganglia which may prevent the movement disorders. Nevertheless an hemichorea-hemiballism in young people must suggest a cerebral toxoplasmosis. Finally a symptomatic treatment is often necessary; in these cases the use of sodium valproate must be considered, this drug being able to induce a clinical improvement.
AIDS-Related Opportunistic Infections↗
[Congenital toxoplasmosis in the Alpes-Maritimes region. Apropos of 26 cases observed between 1984 and 1990].
Twenty-six cases of congenital toxoplasmosis observed in the department of Alpes Maritimes (Chief Town: Nice) between 1984 and 1990 are reported. All affected children were treated by pyrimethamine and sulfonamide as soon as the diagnosis was established. None of them exhibited serious sequellae. In most cases (58%) there were no clinical manifestations in agreement with other reports. Benign manifestations were observed in 10 cases (38%): 4 chorioretinitis; 4 intracranial calcifications: 1 febrile seizure; 7 hyperproteinorachias: 3 isolated and 4 associated with other signs. In 3 cases, secondary lesions appeared during the treatment period. This confirms the need for active therapeutic research in order to decrease the risk of late ocular complication which is the major problem of the disease.
Child↗
[Structural aspects at the individual level in the epidemiological process in human toxoplasmosis].
Intradermoreaction with toxoplasmin in apparently healthy subjects gave positive reactions in 13% of the cases. The mothers of children with neuropsychical diseases and congenital malformations were positive to toxoplasmin in 62-63% of the cases and with the Sabin-Feldman reaction in 9.6-13.8%. High proportions of positive results. (29.1-30%) were obtained with both tests in the children with neuropsychical diseases and congenital malformations. Host-parasite relationships in the early period of embryonic development deeply affects the normal evolution of the embryo and foetus. The individual structural level of the epidemiologic human toxoplasmosis process is conditioned by the moment at which the host-parasite relationships are established.
Adolescent↗
Lymphocytes bearing the gamma delta T-cell receptor in acute toxoplasmosis.
Although the relative and absolute numbers of CD3+ cells (T lymphocytes) were similar in eight children with acquired Toxoplasma gondii infection and 10 uninfected age- and sex-matched healthy controls, the proportion of cells bearing the gamma delta T-cell receptor was significantly higher in the subjects with acute toxoplasmosis. The great majority of gamma delta T cells from the infected patients expressed covalently bound gamma delta chains on their surface, i.e. were BB3+ lymphocytes. Since the gamma delta T-cell subsets exert both restricted and unrestricted major histocompatibility complex cytotoxicity, further research is needed to elucidate the role of gamma delta T cells in the control of this coccidian protozoan infection.
Acute Disease↗
[The risks of pyrimethamine-sulfadoxine combination in the prenatal treatment of toxoplasmosis].
Some of the alternative treatments to avoid termination of pregnancy in cases where the fetus is affected by toxoplasmosis is to treat it as soon as the diagnosis has been made. The authors who already have experience of using pyrimethamine with sulfadoxoine (Fansidar) in the post-natal treatment of congenital infection, thought after reviewing the literature that this association of drugs would be harmless if applied during pregnancy. The principal risk that arises in the fetus is the teratogenicity of each of the components of pyrimethamine and sulfadoxine and also their associations. In animals pyrimethamine can increase the frequency of cleft palates probably because of its antifolinic action but there is no formal proof that it is teratogenic in human beings. Furthermore, the theoretical risk of karnicerus in the new born using the Sulfonamide has not been demonstrated. In the mother the main but rare risk (1 in 75,000) seems to be for the production of severe skin lesions such as Lyell and Stevens-Johnson which could be brought about by sulfonamides, but not particularly sulfadoxine.
Antimalarials↗
Protection of mice and nude rats against toxoplasmosis by a multiple antigenic peptide construction derived from Toxoplasma gondii P30 antigen.
The first part of this work presents the sequence of the first 20 NH2 terminus residues obtained from P30, the major surface Ag of Toxoplasma gondii, purified by HPLC. A synthetic peptide (P30 48-67) has been prepared both in linear form and as a multiple antigenic peptide (MAP) construct. Immunization of mice and rats with the P30 48-67 MAP in the presence of IFA induces high levels of IgG antibodies that recognize both the linear peptide and the MAP construct in ELISA, and P30 in Western blots of NP-40-extracted tachyzoite Ag. Because these sera are negative in immunofluorescence assays with whole tachyzoites, it seems that IgG antibodies induced by P30 48-67 MAP, although recognizing the denatured structure, are unable to recognize the native protein. However, the protective effect of both constructs has then been studied in mice and nude rats. Whereas immunization of mice with the monomeric peptide does not confer any protection against oral infection with 1200 cysts of T. gondii 76K strain (mortality within 11 days), 40% of mice immunized with the MAP construct survived up to 75 days after infection. Nude rats were passively transferred with 5 x 10(4) T lymphocytes from P30 48-67 MAP-immunized Fischer rats before infection with 5 x 10(4) RH strain tachyzoites. They survived up to 40 days after infection and raised an intense IgG antibody response against P30, whereas nude rats transferred with control lymphocytes died within 21 days. This shows that immunization with P30 48-67 MAP also induces an efficient T cell immune response. The present work confirms the recently demonstrated role of P30 in protective immunity and shows the interest of peptide octameric constructions as inducers of partially protective immune responses in toxoplasmosis, as already demonstrated in schistosomiasis.
Amino Acid Sequence↗
[New views on the pathogenesis and diagnosis of toxoplasmosis].
T. gondii is one of the most occurring human pathogenic parasites in Europe. While the majority of immunocompetent individuals with T. gondii infection do not present clinical symptoms, congenital toxoplasmosis and reactivation of a latent infection in immunocompromised patients (i. e. patients with AIDS) are of high clinical relevance. A classification of T. gondii isolates is not available so far, although it was possible to demonstrate strain differences by the use of several methods, i. e. by using monoclonal antibodies. T. gondii seems to be able to infect any mammalian cell. Host cell-derived as well as parasite-derived factors seem to be important for the contact between host cell and parasite and the subsequent internalization. Following invasion, T. gondii is located within a parasitophorous vacuole that does not fuse with lysosomes. The multiplication rate of these obligately intracellular growing parasites decreases during conversion from the tachyzoite stage to the bradyzoite stage. Finally, the bradyzoites-harbouring cysts persist for the lifetime of the host. Reconversion from bradyzoites to tachyzoites may occur in immunocompromised patients. Probably, IFN-gamma is involved in this process. In addition to serological methods, direct detection of T. gondii using PCR or demonstration of circulating antigens might be routinely used as diagnostical tools in the future. Determination of specific IgA antibodies, which can be evaluated using the immunoblot technique, seem to be important for early serological diagnosis. The use of recombinant antigens might be helpful in future diagnosis to circumvent discrepancies between serological test results which could have resulted from strain-specific differences.
Animals↗
Presumed ocular toxoplasmosis presenting as papillitis.
Unilateral papillitis is a rare manifestation of ocular toxoplasmosis. However, other causes of papillitis need to be ruled out before concluding the diagnosis.
Adult↗
Oral trimethoprim-sulfamethoxazole in the treatment of cerebral toxoplasmosis in AIDS patients--a prospective study.
Toxoplasma encephalitis is the commonest cause of intracranial mass lesions in AIDS patients. Effective therapy includes pyrimethamine plus sulfadiazine, clindamycin with pyrimethamine, and co-trimoxazole. This study examines the efficacy of oral co-trimoxazole in 20 AIDS patients with toxoplasmosis and seeks to confirm the experience of Torre et al.
AIDS-Related Opportunistic Infections↗
[Interesting aspects of immunity and immunization against toxoplasmosis].
The immunity developing in the course of infection with Toxoplasma gondii was discussed, pointing out its advantages and shortcomings, then the attempts at immunization against toxoplasmosis were presented.
Animals↗
Toxoplasmosis in pregnant women in Sanliurfa, Southeastern Anatolia City, Turkey.
Blood samples from 1149 pregnant women (age 26.9 +/- 5.3 years; mean 20 weeks gestation) on their first prenatal visit to Obstetrics and Gynecology Department and analyzed for Toxoplasma-specific immunoglobulin (IgM) and immunoglobulin (IgG) by ELISA. 694 (60.4%) of the women were IgG-positive, indicating previous maternal infection, while 35 (3%) were IgM-positive, indicating recent infection, and 420 (38.9%) were sero-negative. The high sero-positive rate may be linked to traditional raw meat consumption. Treatment with spiramycin was effective in preventing congenital toxoplasmosis in children of sero-positive mothers who consented to treatment.
Adult↗
Transmission of toxoplasmosis by bone marrow transplant associated with Campath-1G.
A 12-year-old boy in third remission acute lymphoblastic leukaemia was given a mismatched transplant from his mother. He suffered prolonged neutropenia and pyrexia which was only finally diagnosed as toxoplasmosis using molecular biology methods and by his response to appropriate treatment. This was probably transmitted by bone marrow transplant since maternal immune T cells were removed by the use of Campath-1G and treatment with cyclosporin A probably prevented his IgM immune response and impeded the diagnosis.
Antigens, CD↗