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[Pulmonary toxoplasmosis in AIDS. Report of 3 cases].

Pulmonary toxoplasmosis in AIDS is rare. Its frequency is estimated to be between 0.2 and 3.7% but is probably underestimated; however, it is lower than that of neurotoxoplasmosis and is rarely identified prior to autopsy. We describe herein 3 cases diagnosed in living patients. The clinical presentation is usually severe interstitial pneumonitis, occurring in profoundly immunodeficient patients. Toxoplasma gondii, the infectious agent, must always be sought in the bronchoalveolar lavage of such patients and is sometimes associated with other opportunistic infectious agents, such as Pneumocystis carinii.

Acquired Immunodeficiency Syndrome↗

[Epidemiological study of toxoplasmosis at Kinshasa and in lower Zaire].

An epidemiological survey of human toxoplasmosis was carried out in urban Kinshasa and in rural Kwilu-Ngongo (Bas-Zaïre). First contact with Toxoplasma gondii occurred earlier in children from Kinshasa, but adults aged over 30 were more often carriers of IgG antibodies in Kwilu-Ngongo (65.5%) compared to those in Kinshasa (50.2%). In Zaire, nutritional diet and telluric contact seem to be very important.

Adolescent↗

Prevalence of toxoplasmosis in swine from Iowa.

Of swine from 104 herds, 2,616 were tested for antibodies against Toxoplasma gondii, using an ELISA. Data were analyzed according to swine type, herd size, facility type, and season. The true prevalence of toxoplasmosis was estimated as 5.4% among finishing swine and 11.4% among sows and gilts. Herds with less than 100 breeding swine were significantly (P less than 0.05) more likely to be infected than were herds with greater than or equal to 100 breeding swine. The rate of seropositivity in breeding swine was approximately the same in infected herds, regardless of herd size. Herds with finishing swine maintained in total confinement were as likely to become infected as were herds maintained in other types of facilities, but infected herds with finishing swine maintained in confinement appeared to have a lower in-herd prevalence than did herds maintained in other types of facilities (P = 0.09). Seasonal effects were not observed, and prevalence remained relatively constant throughout the year.

Age Factors↗

Toxoplasmosis and other causes of abortions in sheep from north central United States.

Between 1983 and 1989, we examined 1,201 aborted fetuses and dead lambs from the north central United States. Toxoplasmosis was diagnosed in 17.5%, campylobacteriosis in 9.9%, chlamydiosis in 4.7%, and miscellaneous infections in 15.1%. Inflammatory lesions suggestive of infectious causes were seen in 13%. Noninfectious causes were identified in 6.1%, and a diagnosis was not reached in 33.3%. An agglutination test was used to detect Toxoplasma gondii-specific antibodies in ovine fluids. Toxoplasma gondii antibodies were detected in 223 of 1,064 (20.9%) fluids from fetuses and dead lambs. Of 201 seropostive (greater than or equal to 16) fetuses and lambs, T gondii antibody titers (reciprocal) were 16 (21 fetuses and lambs), 32 (10 fetuses and lambs), 64 (2 fetuses and lambs), 128 (7 fetuses and lambs), 256 (9 fetuses and lambs), 512 (5 fetuses and lambs), 1,024 (15 fetuses and lambs), 2,048 (13 fetuses and lambs), 4,096 (13 fetuses and lambs), 8,196 (13 fetuses and lambs), 16,392 (19 fetuses and lambs), and greater than or equal to 32,784 (74 fetuses and lambs).

Abortion, Habitual↗

Fatal toxoplasmosis in koalas (Phascolarctos cinereus).

Toxoplasma gondii-like organisms were seen in the heart, kidney, liver, lung, lymph node, spleen, small intestine, and stomach from 2 koalas that died suddenly in a fauna park in Sydney, Australia. Diagnosis was confirmed by immunohistochemical staining. This is the first confirmed report of toxoplasmosis in an arboreal marsupial.

Animals↗

The role of single sample detection of specific anti-Toxoplasma IgM in accurate evaluation of seroconversion during acquired toxoplasmosis.

Specific IgM anti-Toxoplasma antibodies were sought in 94 serum samples by means of D.S. IgM ELISA. These antibodies were detected in all cases of acute toxoplasmic lymphadenopathy, but up to 13 months from onset of symptoms and in out of 20 patients with chronic toxoplasmosis and in one out of 20 seronegative individuals. They were neither detected in samples from 4 infants with high IgG IFAT titres associated with hydrocephalus and cerebral calcification, nor in samples from patients containing rheumatoid factors and those with lymphoma or infectious mononucleosis. Thus the detection of IgM antibodies seems non decisive mean for identifying infected infants and for determination of the exact date of acquiring the infection.

Animals↗

[Acute pancytopenia induced by pyrimethamine during treatment of cerebral toxoplasmosis associated with AIDS. Role of dihydrofolate reductase inhibitors].

An AIDS patient with cerebral toxoplasmosis had a folate deficiency-induced acute pancytopenia, which was rapidly reversed by the administration of folic acid. This observation is particularly important as a possible preventive therapy to be given to all HIV-infected patients because of the anti-folic activity of the majority of anti-infectious agents used during the course of this disease and the many potential sites of hematopoietic involvement. The patient's condition is stressed because the undernourished subject is at greater risk for this type of manifestation.

Acquired Immunodeficiency Syndrome↗

[Bilateral traction detachment in necrotizing retinitis as a sequela of toxoplasmosis].

A 35-year-old patient with systemic lupus erythematodes is presented. Two weeks after initiation of an immunosuppressive therapy with steroids and cyclophosphamide she developed a bilateral acute necrotising retinitis. Although the infiltration of the vitreous body was only slight the right eye developed a traction retinal detachment within a few days. A vitrectomy was performed but the situation was found to be inoperable due to central necrotic areas. Two days later serological specimen revealed an acute toxoplasmosis as the cause of the bilateral retinitis in this patient. A therapy with sulfadiazine and pyrimethamine was started immediately. Nevertheless two weeks later traction retinal detachment occurred also in the left eye. A reattachment of the retina could be achieved by vitreoretinal surgery.

Adult↗

Diagnosis of transplacentally induced toxoplasmosis in pigs.

Seventeen sows were fed 1,000 Toxoplasma gondii oocysts of isolates GT-1 or PT-1 at 32 to 92 days of gestation, and the products of conception were examined for T gondii antibodies and parasites. Twelve of these sows were euthanatized near term between 21 and 62 days after being fed T gondii; fetal body fluids or fetal sera were examined for agglutinating T gondii antibodies, and tissues were bioassayed in mice for T gondii parasites. Six sows produced pigs that had been transplacentally infected with T gondii; one of them aborted a T gondii-infected fetus 17 days after ingesting oocytes. Agglutinating antibodies were detected in fetuses infected in utero, but transplacental transfer of T gondii antibodies was not observed in noninfected fetuses. Transcolostrally acquired T gondii antibodies disappeared by 3 months of age. Diagnosis of transplacental toxoplasmosis was confirmed on the basis of detection of T gondii organisms in fetal tissues by use of histologic examination and bioassay in mice. In conclusion, finding of T gondii antibodies in body fluids could serve as a rapid screening test for transplacental T gondii infection in pigs.

Animals↗

[Difficulties in the diagnosis of chronic toxoplasmosis with lung involvement].

A case of chronic acquired toxoplasmosis combined with lung impairment is described. The diagnosis was made on the basis of the data obtained as a result of the use of the latest clinical and instrumental research methods and a specific serologic test. The diagnosis was verified morphologically on thin sections of the sputum. The authors provide data on the diagnostic search for approaches to the differentiation between parasitic diseases resulting in dissemination to the lungs with calcification of the foci and broncholithiasis, tuberculosis.

Animals↗

Cerebral toxoplasmosis in patients with AIDS.

Toxoplasma gondii, a previously rare cause of central nervous system infection, has become a major cause of encephalitis in patients with acquired immunodeficiency syndrome. The diagnosis of cerebral toxoplasmosis should be kept in mind when neurologic signs and symptoms develop in patients with AIDS. Patients with positive serology and characteristic lesions on computed tomographic scans should receive two weeks of antitoxoplasma therapy. Biopsy is recommended for patients with atypical presentation, negative serology, progressive clinical deterioration or differential response of lesions to empiric therapy.

Acquired Immunodeficiency Syndrome↗

The effect of transfer factor on lymph node morphology in murine toxoplasmosis.

Mice were infected intraperitoneally with a low virulence strain of Toxoplasma gondii (TO) and transfer factor (TF) was prepared from the spleens of infected (TFT) and uninfected control mice (TFC). Three experimental groups of 12 mice were given either saline, TFC or TFT, by intraperitoneal injection. After 24 h half of each group of these animals were infected by intraperitoneal injection of TO cysts. In three separate experiments animals were killed at 11, 28 and 35 days and the flank and axillary nodes removed for histological examination. There was generalized lymph node enlargement with cortical and paracortical expansion. In most animals there was diffuse infiltration of the nodes by clusters of histiocytes. Administration of TFC alone led to a mild increase in node size at 11 and 28 days. Administration of TFT alone had a moderate stimulatory effect on the mouse lymph nodes with a significant increase in size at 11 days due predominantly to expansion of the paracortex. Administration of TFT and TFC followed by inoculation of TO led to an increased and more consistent histiocyte response and an increased number of paracortical T blasts compared with animals given TO alone. TFT and TFC had no demonstrable protective effect in experimental murine toxoplasmosis as assessed by quantitation of toxoplasma brain cysts. The effect of transfer factor was not antigen specific in this system.

Animals↗

[Seroepidemiologic aspects of toxoplasmosis in 2 municipalities of the province of Ciego de Avila. September 1985].

A seroepidemiologic study of toxoplasmosis was made in Ciego de Avila province. By means of an ELISA for toxoplasma, blood samples from 284 people from the Ciego de Avila and Majagua districts were examined, for a 55.9% prevalence. An association with various factors, such as eating raw meat, contract with the earth, having cats at home, and rural origin with the occurrence of infection. 89.3% of positive sera ranged from 1:400 to 1:800 which are low titers.

Adolescent↗

Herpes zoster ophthalmicus, contralateral hemiplegia, and recurrent ocular toxoplasmosis in a patient with acquired immune deficiency syndrome-related complex.

A 42-year-old man presented with herpes zoster ophthalmicus on the right side. He was found to have acquired immune deficiency syndrome-related complex. Two weeks later he developed toxoplasmic retinochoroiditis in the left eye. He also presented later with left hemiplegia, which was probably caused by herpes zoster arteritis. Nine months after the retinal lesion resolved he developed another area of toxoplasmic retinochoroiditis adjacent to the first lesion. Herpes zoster may be the first presentation of acquired immune deficiency syndrome-related complex in a young healthy individual. Ophthalmologists are encountering patients with acquired immune deficiency syndrome who may have multiple organisms as the cause for their ocular infections and this might pose a treatment dilemma. The combination of herpes zoster ophthalmicus and ocular toxoplasmosis in this patient makes this case unusual.

Acquired Immunodeficiency Syndrome↗

[Epidemiology of toxoplasmosis in Ivory Coast].

The purpose of this study was to determine the prevalence of toxoplasmosis in samples of healthy populations in Ivory Coast. Various factors have been studied: age, sex, ethnic group, occupation, food, contacts with animals, climate. The samples were obtained in four places which were different by geographical situation and climate: Abidjan (urban site), Bonoua (littoral site), Bin-Houye (forest site), Odienne (predesert site). The samples of sera or blood were deposited on filter-papers and tested by latex agglutination (for IgG) and ISAGA (for IgM). Results were analysed by statistical methods. More than 2,000 samples have been studied, showing a prevalence higher in humid tropical zones (55.6% to 70%) than in predesert zone (37.2%). The first contact of the child with the parasite was more often before reaching 10 years but the risk for women was important until the age of 20. The other studied factors didn't appear to have any effect.

Adolescent↗

[Neurohumoral and immune homeostasis in experimental toxoplasmosis in white rats].

The intraperitoneal inoculation of Toxoplasma gondii strain RH into white rats is accompanied by the disorganization of choline-and histamine-energic activity, which, on one hand, facilitates the spread of the infective agent throughout the body and, on the other hand, activates nonspecific and specific protective factors. The toxoplasmic antigen appears in the blood stream as early as 24 hours after inoculation. Its penetration into tissues coincides with the activation of complement, this activation first following the alternative pathway and then, after the appearance of antibodies, the classical pathway. The increase of the titers of specific antibodies favors the formation of subcompensation in the acetylcholine and histamine systems and is accompanied by the elimination of the parasites from internal organs and their migration to the brain. Such complex immunological investigations provide useful information making it possible to explain some specific features of the pathogenesis of toxoplasmosis.

Animals↗

[Toxoplasmosis in dogs in Greece].

In Greece, not only raw meat feeding but also the possible faecal transmission of disease from the vast amount of strayed domestic cats play an important role in the incidence of toxoplasmosis among dogs. This must be concluded from the high contamination rate of 21.2% to 30.8% in all four presented investigations.

Animals↗

[Toxoplasmosis and abortion in patients at the O'Horan Hospital of Merida, Yucatan].

The relationship between abortion and infection by Toxoplasma gondii was analyzed in 100 cases of spontaneous abortions, 51 of which corresponded to single abortions and 49 to cases with a history of repeated abortions. The Sabin-Feldman test was used for the detection of specific antibodies. Parasites were identified and isolated in the aborted material; sections were stained by Hematoxilin-Eosin, processed for indirect immunofluorescence and inoculated into mice. Antibodies to Toxoplasma were detected in 47 percent of the total study population. Positive identification of parasites in the decidua and corionic villae was established in 2 percent of the patients studied. Parasites could only be isolated in one of these patients. Both cases belonged to the group with positive serology and antibody titers of 1:64 and 1:128, and having experienced a single abortion. There was no significant statistical difference with regard to antibody titers between the single abortion and repeated abortion groups. Our results indicate an important causative relationship between toxoplasmosis and abortions in Mérida, Yucatán, México.

Abortion, Habitual↗