The Experiences and Recommendations of Families with Children Who Have Congenital Toxoplasmosis

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Roberts, Jillian; Mortimer, Tamara; Mish, Sandra; Kerns, Kimberly; Jagdis, Frank; MacMath, Sheryl

2005-01-01

Toxoplasmosis infections are usually asymptomatic in health hosts, but can cause serious, sometimes life threatening, sequelae in infants when the mother acquires an acute infection during pregnancy and the parasite is transmitted via the placenta to the developing fetus. This article is part of a comprehensive research project investigating the…

Branch Retinal Artery Occlusion Caused by Toxoplasmosis in an Adolescent

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Elizabeth Chiang

2012-10-01

Full Text Available Purpose: Branch retinal artery occlusion (BRAO, while not uncommon in elderly patient populations, is rare in children and adolescents. We report a case of a BRAO secondary to toxoplasmosis in this demographic. Case: A previously healthy 17-year-old male developed a unilateral BRAO in conjunction with inflammation and increased intraocular pressure. Family history was positive for cerebrovascular accidents in multiple family members at relatively young ages. The patient had a hypercoagulable workup as well as a cardiovascular workup which were both normal. A rheumatologic workup was unremarkable. By 3 weeks, a patch of retinitis was more easily distinguished from the BRAO and the diagnosis of ocular toxoplasmosis was made. Treatment was started with prednisone and azithromycin with subsequent improvement in vision. Toxoplasma antibody levels were elevated for IgG and negative for IgM, IgA, and IgE. The etiology of the BRAO was attributed to ocular toxoplasmosis. Conclusions: Vascular occlusions are rare in toxoplasmosis. This is the third case report of a BRAO in a patient in the pediatric population. The diagnosis of ocular toxoplasmosis should be considered in young patients with retinal artery occlusions associated with inflammation.

Toxoplasmosis: An Important Protozoan Zoonosis

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Sonar S. S. and Brahmbhatt M.N.

Full Text Available Toxoplasmosis is an important infection caused by single celled parasite Toxoplasma gondii which is one of the world's most common parasites. Toxoplasmosis is considered to be the third leading cause of death attributed to food-borne illness in the United States. Most people affected never develop signs and symptoms. But for infants born to infected mothers and for people with compromised immune systems, toxoplasmosis can cause extremely serious complications. Toxoplasmosis was first described in 1908 from a small rodent. The parasite infects almost all worm blooded animals and serological evidence indicates that it is one of the most common of humans’ infections throughout the world. The disease is transmitted mainly by ingestion of infective stage of the parasite, organ transplant as well as blood transfusion in addition to the transplacental transmission which is very common. Toxoplasmosis can be presented in various forms of clinical manifestations depending on the immune status of the patient causing life threatening disease in AIDS patient. Pregnant women, cat owners, veterinarians, abattoir workers, children, cooks, butchers are considered as high risk group. Timely treatment of man and animals with proper antibiotic, hygienic measures, proper disinfection, mass education and vaccination are the measures to curtail the disease. [Veterinary World 2010; 3(9.000: 436-439

Toxoplasmosis: An Important Message for Cat Owners

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... role do cats play in the spread of toxoplasmosis? Cats get Toxoplasma infection by eating infected rodents, ... an infected cat may have defecated. What is toxoplasmosis? Toxoplasmosis is an infection caused by a microscopic ...

Animals are key to human toxoplasmosis.

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Schlüter, Dirk; Däubener, Walter; Schares, Gereon; Groß, Uwe; Pleyer, Uwe; Lüder, Carsten

2014-10-01

Toxoplasma gondii is an extremely sucessfull protozoal parasite which infects almost all mamalian species including humans. Approximately 30% of the human population worldwide is chronically infected with T. gondii. In general, human infection is asymptomatic but the parasite may induce severe disease in fetuses and immunocompromised patients. In addition, T. gondii may cause sight-threatening posterior uveitis in immunocompetent patients. Apart from few exceptions, humans acquire T. gondii from animals. Both, the oral uptake of T. gondii oocysts released by specific hosts, i.e. felidae, and of cysts persisting in muscle cells of animals result in human toxoplasmosis. In the present review, we discuss recent new data on the cell biology of T. gondii and parasite diversity in animals. In addition, we focus on the impact of these various parasite strains and their different virulence on the clinical outcome of human congenital toxoplasmosis and T. gondii uveitis. Copyright © 2014 Elsevier GmbH. All rights reserved.

TOXOPLASMOSIS: FOOD SAFETY AND RISK COMMUNICATION

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G. V. Celano

2010-06-01

Full Text Available Toxoplasmosis, parasitic pathology supported by Toxoplasma gondii, is a typical example of multi-issue and inter-disciplinary on which, with equal intensity, converge the interests of various branches of human and veterinary medicine. The aim of research was the assessment of risk communication to pregnant women by doctors gynecologists involved in ASL’s territorial about toxoplasmosis, which can have serious effects on pregnancy and the unborn child. The results acquired during the investigation showed the need to develop and implement appropriate information campaigns and proper nutrition education.

Toxoplasmosis : Beware of Cats !!!

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Rubina Kumari Baithalu

2010-10-01

Full Text Available Anthropozoonotic parasite Toxoplasma gondii causes widespread human and animal diseases, mostly involving central nervous system. Human acquires toxoplasmosis from cats, from consuming raw or undercooked meat and from vertical transmission to the fetus through placenta from mother during pregnancy. Socio-epidemiological as well as unique environmental factors also plays a significant role in transmission of this infection. Preventive measures should be taken into account the importance of culture, tradition, and beliefs of people in various communities more than solving poverty and giving health education. Therefore the focus of this article is to create public awareness regarding sense of responsibility of looking after pets to prevent such an important zoonotic disease. [Vet. World 2010; 3(5.000: 247-249

The Austrian Toxoplasmosis Register, 1992-2008.

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Prusa, Andrea-Romana; Kasper, David C; Pollak, Arnold; Gleiss, Andreas; Waldhoer, Thomas; Hayde, Michael

2015-01-15

We aimed to determine the incidence of primary gestational infections with Toxoplasma gondii and congenital toxoplasmosis in Austria, a country with a nationwide prenatal serological screening program since 1974. We analyzed retrospective data from the Austrian Toxoplasmosis Register of pregnant women with Toxoplasma infection and their offspring with births between 1992 and 2008, identified by the prenatal mandatory screening program. Treatment was administered to women from diagnosis of a Toxoplasma infection until delivery. Infected infants were treated up to 1 year of life routinely. Clinical manifestations in infected infants were monitored at least for 1 year and documented in the register. The Austrian Toxoplasmosis Register included 2147 pregnant women with suspected Toxoplasma infection. Annually, 8.5 per 10 000 women acquired Toxoplasma infection during pregnancy, and 1.0 per 10 000 infants had congenital toxoplasmosis (13% mean transmission rate). Our data showed that women treated according to the Austrian scheme had a 6-fold decrease in the maternofetal transmission rate compared to women without treatment. Results from the Austrian Toxoplasmosis Register show the efficiency of the prenatal screening program. Our results are of clinical relevance for infants, healthcare systems, and policy makers to consider preventive Toxoplasma screening as a potential tool to reduce the incidence of congenital toxoplasmosis. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

PATHOGENETIC MECHANISMS OF CHRONIC ACQUIRED TOXOPLASMOSIS

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Kotsyna S.S.

2015-05-01

Full Text Available Introduction. Toxoplasma gondii is an intracellular protozoan that infects approximately one-third of the world’s population. Infection in human generally occurs through consuming food or drink contaminated with oocysts and tissue cysts from undercooked meat. Although latent infection with Toxoplasma gondii is among the most prevalent of human infections, it has been generally assumed that, except for congenital transmission, it is asymptomatic. Different conditions such as, number of parasite, virulence of the organism, genetic background, sex, and immunological status seem to affect the course of infection The demonstration that Toxoplasma infections can alter behavior, reproductive function in patients has led to a reconsideration of this assumption. During chronic acquired toxoplasmosis (САT identified the regularities of changes in the ratio of the immune system and the basal levels of sex hormones available informative methods, which made it possible to evaluate the severity of the flow chart and predict treatment outcome without resorting to complex research methods. Found that the host-parasite relationships and clinical manifestations of chronic toxoplasmosis depend largely on protective and adaptive responses and compensatory abilities of the human body. Material & methods. 112 patients attended in the 6 Department of Kharkiv Regional Infectious Diseases Hospital №22 (Department of Medical Parasitology and Tropical Diseases of Kharkiv Medical Academy of Postgraduate Education, in Kharkiv, Ukraine were enrolled in the study. Forty four patients (39,3±4,6% were male and sixty eight (60,7±4,6% were female. The age of the patients was 18 till 72 years. Results & discussion. All of 112 CAT patients had subjective clinical symptoms in various combinations: increased fatigue 99,1 ± 0,9%, headache and tiredness 95,5 ± 1,9%, pain in the liver 88,4 ± 3,1%, bitter taste in the mouth 93,8 ± 2,2%, muscle pain 81,3 ± 3,7% and joint pain

Toxoplasmosis (For Parents)

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... Staying Safe Videos for Educators Search English Español Toxoplasmosis KidsHealth / For Parents / Toxoplasmosis What's in this article? ... t show any signs of a toxoplasmosis infection.) Toxoplasmosis in Kids In kids, toxoplasmosis infections can be: ...

Hyperdense lesions in CT of cerebral toxoplasmosis

International Nuclear Information System (INIS)

Quinones Tapia, D.; Ramos Amador, A.; Monereo Alonso, A.

1994-01-01

We report a case of cerebral toxoplasmosis in a patient with stage IV C 1 AIDS who presented hyperdense CT images 13 days after beginning antitoxoplasma treatment. These lesions could be caused by calcifications or blood. The attenuation values lead us to believe that they are calcium. Intracranial calcification in adult cerebral toxoplasmosis is an uncommon finding. Its presence in AIDS patients should not suggest any etiology other than toxoplasmosis. (Author) 16 refs

Unrecognized Ingestion of Toxoplasma gondii Oocysts Leads to Congenital Toxoplasmosis and Causes Epidemics in North America

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Boyer, Kenneth; Hill, Dolores; Mui, Ernest; Wroblewski, Kristen; Karrison, Theodore; Dubey, J. P.; Sautter, Mari; Noble, A. Gwendolyn; Withers, Shawn; Swisher, Charles; Heydemann, Peter; Hosten, Tiffany; Babiarz, Jane; Lee, Daniel

2011-01-01

(See the Editorial Commentary by Linn, on pages 1090–1.) Background. Congenital toxoplasmosis presents as severe, life-altering disease in North America. If mothers of infants with congenital toxoplasmosis could be identified by risks, it would provide strong support for educating pregnant women about risks, to eliminate this disease. Conversely, if not all risks are identifiable, undetectable risks are suggested. A new test detecting antibodies to sporozoites demonstrated that oocysts were the predominant source of Toxoplasma gondii infection in 4 North American epidemics and in mothers of children in the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS). This novel test offered the opportunity to determine whether risk factors or demographic characteristics could identify mothers infected with oocysts. Methods. Acutely infected mothers and their congenitally infected infants were evaluated, including in-person interviews concerning risks and evaluation of perinatal maternal serum samples. Results. Fifty-nine (78%) of 76 mothers of congenitally infected infants in NCCCTS had primary infection with oocysts. Only 49% of these mothers identified significant risk factors for sporozoite acquisition. Socioeconomic status, hometown size, maternal clinical presentations, and ethnicity were not reliable predictors. Conclusions. Undetected contamination of food and water by oocysts frequently causes human infections in North America. Risks are often unrecognized by those infected. Demographic characteristics did not identify oocyst infections. Thus, although education programs describing hygienic measures may be beneficial, they will not suffice to prevent the suffering and economic consequences associated with congenital toxoplasmosis. Only a vaccine or implementation of systematic serologic testing of pregnant women and newborns, followed by treatment, will prevent most congenital toxoplasmosis in North America. PMID:22021924

Toxoplasmosis and pregnancy.

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Chaudhry, Shahnaz Akhtar; Gad, Nanette; Koren, Gideon

2014-04-01

Question Congenital toxoplasmosis is a dangerous fetal infection. Why is routine screening for Toxoplasma gondii infection during pregnancy not available for most Canadians? Answer Low prevalence of the infection, high cost associated with testing, low sensitivity of screening tests, false-positive test results, and limitations of treatment effectiveness are all cited as reasons for not routinely screening for T gondii infection in Canada. Currently, screening for the detection of T gondii is only performed in Nunavik and other parts of northern Quebec owing to the high prevalence of infection in this region. Congenital toxoplasmosis causes neurologic or ocular disease (leading to blindness), as well as cardiac and cerebral anomalies.

Magnetic resonance evaluation of cerebral toxoplasmosis in patients with the acquired immunodeficiency syndrome

International Nuclear Information System (INIS)

Batra, A; Tripathi, R.P.; Gorthi, S.P.

2004-01-01

PURPOSE: To evaluate and delineate the characteristics of cerebral toxoplasmosis lesions using a combination of magnetic resonance (MR) spectroscopy, diffusion, and perfusion studies. MATERIAL AND METHODS: A total of 8 patients with 23 lesions were evaluated on a 1.5-T MR system. Diffusion-weighted imaging (DWI) was performed with three 'b' values of 50, 500, and 1000 s/mm2, and the apparent diffusion coefficient maps were calculated. The diffusion-weighted appearances and the T2-weighted MR appearances of the lesions were compared. MR spectroscopy was performed using the point-resolved single-voxel technique with two TE values of 135 ms and 270 ms. Perfusion studies were carried out using the dynamic contrast-enhanced technique, and the relative cerebral blood volume maps were qualitatively and quantitatively analyzed. RESULTS: DWI revealed the majority of the lesions as having increased diffusion within their necrotic centers, with the ADC ranging from 0.5 to 3.01 (mean ± SD: 1.49 ± 0.7). All the lesions revealed a predominant lipid peak on MR spectroscopy and were extremely hypovascular on perfusion MR studies. CONCLUSION: MR diffusion, spectroscopy, and perfusion studies help in characterizing toxoplasmosis lesions and, in most cases, can be used in combination to help establish the diagnosis of toxoplasmosis

Magnetic resonance evaluation of cerebral toxoplasmosis in patients with the acquired immunodeficiency syndrome

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Batra, A; Tripathi, R.P.; Gorthi, S.P. [Inst. of Nuclear Medicine and Allied Sciences, Delhi (India). NMR Research Center

2004-04-01

PURPOSE: To evaluate and delineate the characteristics of cerebral toxoplasmosis lesions using a combination of magnetic resonance (MR) spectroscopy, diffusion, and perfusion studies. MATERIAL AND METHODS: A total of 8 patients with 23 lesions were evaluated on a 1.5-T MR system. Diffusion-weighted imaging (DWI) was performed with three 'b' values of 50, 500, and 1000 s/mm2, and the apparent diffusion coefficient maps were calculated. The diffusion-weighted appearances and the T2-weighted MR appearances of the lesions were compared. MR spectroscopy was performed using the point-resolved single-voxel technique with two TE values of 135 ms and 270 ms. Perfusion studies were carried out using the dynamic contrast-enhanced technique, and the relative cerebral blood volume maps were qualitatively and quantitatively analyzed. RESULTS: DWI revealed the majority of the lesions as having increased diffusion within their necrotic centers, with the ADC ranging from 0.5 to 3.01 (mean {+-} SD: 1.49 {+-} 0.7). All the lesions revealed a predominant lipid peak on MR spectroscopy and were extremely hypovascular on perfusion MR studies. CONCLUSION: MR diffusion, spectroscopy, and perfusion studies help in characterizing toxoplasmosis lesions and, in most cases, can be used in combination to help establish the diagnosis of toxoplasmosis.

Relevance of and New Developments in Serology for Toxoplasmosis.

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Dard, Céline; Fricker-Hidalgo, Hélène; Brenier-Pinchart, Marie-Pierre; Pelloux, Hervé

2016-06-01

Toxoplasmosis is a widespread parasitic disease caused by the intracellular parasite Toxoplasma gondii with a wide spectrum of clinical outcomes. The biological diagnosis of toxoplasmosis is often difficult and of paramount importance because clinical features are not sufficient to discriminate between toxoplasmosis and other illnesses. Serological tests are the most widely used biological tools for the diagnosis of toxoplasmosis worldwide. This review focuses on the crucial role of serology in providing answers to the most important questions related to the epidemiology and diagnosis of toxoplasmosis in human pathology. Notwithstanding their undeniable importance, serological tools need to be continuously improved and the interpretation of the ensuing results remains complex in many circumstances. Copyright © 2016 Elsevier Ltd. All rights reserved.

Toxoplasmosis (Toxoplasma infection) Treatment

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... Form Controls Cancel Submit Search the CDC Parasites - Toxoplasmosis (Toxoplasma infection) Note: Javascript is disabled or is ... message, please visit this page: About CDC.gov . Toxoplasmosis General Information Toxoplasmosis FAQs Toxoplasmosis & Pregnancy FAQs Epidemiology & ...

Cerebral toxoplasmosis after haematopoietic stem cell transplantation

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Agnieszka Zaucha-Prażmo

2017-05-01

Full Text Available Toxoplasmosis is an opportunistic infection caused by the parasite Toxoplasma gondii. The infection is severe and difficult to diagnose in patients receiving allogeneic haematopoietic stem cell transplantation (HSCT. It frequently involves the central nervous system. The case is presented of cerebral toxoplasmosis in a 17-year-old youth with Fanconi anaemia treated with haematopoietic stem cell transplantation (HSCT

Trends, productivity losses, and associated medical conditions among toxoplasmosis deaths in the United States, 2000-2010.

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Cummings, Patricia L; Kuo, Tony; Javanbakht, Marjan; Sorvillo, Frank

2014-11-01

Few studies have quantified toxoplasmosis mortality, associated medical conditions, and productivity losses in the United States. We examined national multiple cause of death data and estimated productivity losses caused by toxoplasmosis during 2000-2010. A matched case-control analysis examined associations between comorbid medical conditions and toxoplasmosis deaths. In total, 789 toxoplasmosis deaths were identified during the 11-year study period. Blacks and Hispanics had the highest toxoplasmosis mortality compared with whites. Several medical conditions were associated with toxoplasmosis deaths, including human immunodeficiency virus (HIV), lymphoma, leukemia, and connective tissue disorders. The number of toxoplasmosis deaths with an HIV codiagnosis declined from 2000 to 2010; the numbers without such a codiagnosis remained static. Cumulative disease-related productivity losses for the 11-year period were nearly $815 million. Although toxoplasmosis mortality has declined in the last decade, the infection remains costly and is an important cause of preventable death among non-HIV subgroups. © The American Society of Tropical Medicine and Hygiene.

Hemorrhagic abscess in a patient with the acquired immunodeficiency syndrome

International Nuclear Information System (INIS)

Casado-Naranjo, I.; Lopez-Trigo, J.; Ferrandiz, A.; Cervello, A.; Navarro, V.

1989-01-01

Cerebral toxoplasmosis is frequent among patients with the acquired immunodeficiency syndrome. The common computed tomography appearance of this complication is multiple low density area with ring enhancement. We describe a very rare picture of cerebral toxoplasmosis, this is multiple hemorrhagic toxoplasmic abscess. (orig.)

Evaluation of seroepidemiological toxoplasmosis in HIV/AIDS patients in the south of Brazil

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Graciela Augusto Xavier

2013-02-01

Full Text Available Toxoplasmosis is considered one of the opportunistic infections for individuals with the Acquired Immunodeficiency Syndrome (AIDS, and is also a major cause of morbidity and mortality. The aim of this study was to evaluate the prevalence of neurotoxoplasmosis, ocular toxoplasmosis and antibodies for Toxoplasma gondii in HIV-positive patients attending the SAE (Specialized Assistance Service for HIV/AIDS, as well as to associate their serological profile with epidemiological and clinical data. A total of 250 patients participated in the study from December, 2009 to November, 2010. Serological analysis was performed using the indirect immunofluorescent technique; epidemiological data were gathered by a questionnaire, and clinical history was based on the analysis of medical charts. Prevalence of seropositivity was 80%, with history of neurotoxoplasmosis in 4.8% and of ocular toxoplasmosis in 1.6% of the patients. The Highly Active Antiretroviral Treatment (HAART was not used by 32% of the patients, 18.4% of the patients had CD4+ T- lymphocyte count less than 200 cells/mm³ and 96.8% of them were not aware of the modes of disease transmission. These findings led us to conclude that the study population is at high risk of clinical toxoplasmosis, because of both reactivation of infection in the seropositive patients who do not make a regular use of HAART, and primo-infection in seronegative patients worsened by an unawareness of the modes of infection reported in this study.

Epidemiology of Ocular Toxoplasmosis

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Petersen, E.; Kijlstra, A.; Stanford, M.

2012-01-01

Retinal infection with Toxoplasma gondii is the most important cause of posterior uveitis, whereby prevalence and incidence of ocular symptoms after infection depend on socio-economic factors and the circulating parasite genotypes. Ocular toxoplasmosis is more common in South America, Central

Trends, Productivity Losses, and Associated Medical Conditions Among Toxoplasmosis Deaths in the United States, 2000–2010

Science.gov (United States)

Cummings, Patricia L.; Kuo, Tony; Javanbakht, Marjan; Sorvillo, Frank

2014-01-01

Few studies have quantified toxoplasmosis mortality, associated medical conditions, and productivity losses in the United States. We examined national multiple cause of death data and estimated productivity losses caused by toxoplasmosis during 2000–2010. A matched case–control analysis examined associations between comorbid medical conditions and toxoplasmosis deaths. In total, 789 toxoplasmosis deaths were identified during the 11-year study period. Blacks and Hispanics had the highest toxoplasmosis mortality compared with whites. Several medical conditions were associated with toxoplasmosis deaths, including human immunodeficiency virus (HIV), lymphoma, leukemia, and connective tissue disorders. The number of toxoplasmosis deaths with an HIV codiagnosis declined from 2000 to 2010; the numbers without such a codiagnosis remained static. Cumulative disease-related productivity losses for the 11-year period were nearly $815 million. Although toxoplasmosis mortality has declined in the last decade, the infection remains costly and is an important cause of preventable death among non-HIV subgroups. PMID:25200264

Drugs in development for toxoplasmosis: advances, challenges, and current status.

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Alday, P Holland; Doggett, Joseph Stone

2017-01-01

Toxoplasma gondii causes fatal and debilitating brain and eye diseases. Medicines that are currently used to treat toxoplasmosis commonly have toxic side effects and require prolonged courses that range from weeks to more than a year. The need for long treatment durations and the risk of relapsing disease are in part due to the lack of efficacy against T. gondii tissue cysts. The challenges for developing a more effective treatment for toxoplasmosis include decreasing toxicity, achieving therapeutic concentrations in the brain and eye, shortening duration, eliminating tissue cysts from the host, safety in pregnancy, and creating a formulation that is inexpensive and practical for use in resource-poor areas of the world. Over the last decade, significant progress has been made in identifying and developing new compounds for the treatment of toxoplasmosis. Unlike clinically used medicines that were repurposed for toxoplasmosis, these compounds have been optimized for efficacy against toxoplasmosis during preclinical development. Medicines with enhanced efficacy as well as features that address the unique aspects of toxoplasmosis have the potential to greatly improve toxoplasmosis therapy. This review discusses the facets of toxoplasmosis that are pertinent to drug design and the advances, challenges, and current status of preclinical drug research for toxoplasmosis.

Toxoplasmosis Testing

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... 2013. Ryder, J. (Updated 2013 September 30). Toxoplasmosis Pathology. Medscape Reference [On-line information]. Available online at ... 2010. Singh, N. and Thomas, F. (Updated 2010 March 23). HIV-1 Associated Opportunistic Infections - CNS Toxoplasmosis. ...

Nephrotic syndrome with a nephritic component associated with toxoplasmosis in an immunocompetent young man.

OpenAIRE

Barrios, Julio E; Duran Botello, Claudia; González Velásquez, Tania

2012-01-01

Introduction: Although the association of infection by toxoplasmosis with the development of nephrotic syndrome is uncommon, cases of this association have nevertheless been reported in the literature for more than two decades, not only for congenital toxoplasmosis, but also in acquired cases, and occasionally in immunocompetent patients. Development: A case is presented of an immunocompetent patient aged 15 with clinical and laboratory indications of nephrotic/nephritic syndrome, in whom ser...

Toxoplasmosis (Toxoplasma infection) Disease Symptoms

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... Form Controls Cancel Submit Search the CDC Parasites - Toxoplasmosis (Toxoplasma infection) Note: Javascript is disabled or is ... message, please visit this page: About CDC.gov . Toxoplasmosis General Information Toxoplasmosis FAQs Toxoplasmosis & Pregnancy FAQs Epidemiology & ...

Differentiation of toxoplasmosis and lymphoma in HIV-positive patients with gadolinium-enhanced MR imaging

International Nuclear Information System (INIS)

Eisenberg, A.D.; Mani, J.R.; Norman, D.

1990-01-01

This paper determines whether gadolinium-enhanced MR imaging can be used to differentiate toxoplasmosis and lymphoma in patients with acquired immunodeficiency syndrome. One hundred fifty-nine lesions from 71 MR examinations of eight patients with lymphoma were evaluated for size, location, enhancement characteristics, lesion multiplicity. Multiple lesions occurred in 72% of toxoplasmosis and 75% of lymphoma cases. Toxoplasmosis lesions are smaller, with lesion most commonly between 1 and 2 cm, whereas lymphoma is most often between 2 and 3 cm. Except for a propensity for lymphoma to occur in the temporal lobes, no difference in lesion location was found. Both conditions usually markedly enhance, but the pattern of enhancement differs

Toxoplasmosis as a food-borne infection

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Đurković-Đaković, O.

2017-09-01

Toxoplasma gondii is a globally distributed parasite that infects all mammals, including one third of the world population. Long known to cause disease in the developing foetus and in immunosuppressed individuals, a body of data that has emerged in the past decades suggests its role in human pathology may be even more important. The WHO and FAO have recently established toxoplasmosis as a foodborne infection of global concern, with a disease burden the greatest of all parasitic infections. Transmission of toxoplasmosis occurs by ingesting tissue cysts from undercooked meat and meat products, and oocysts from the environment with contaminated fresh produce or water. This review provides an update on the current understanding of toxoplasmosis, focusing on the risk of infection from food of animal origin, with particular reference to the risk in Serbia and the region of South-East Europe.

Frequency of Toxoplasmosis in Water Buffalo (Bubalus bubalis in Trinidad

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Anil Persad

2011-01-01

Full Text Available Toxoplasmosis has been reported to occur in several animals and humans causing different clinical manifestations. The study was conducted to determine the frequency of Toxoplasma gondii antibodies (IgG in water buffalo (Bubalus bubalis across farms in Trinidad using a latex agglutination test. Of a total of 333 water buffalo tested, 26 (7.8% were seropositive for T. gondii antibodies. Seropositivity for toxoplasmosis was statistically significantly (P0.05; χ2. This is the first documentation of toxoplasmosis in water buffalo in Trinidad.

Congenital toxoplasmosis.

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Kieffer, François; Wallon, Martine

2013-01-01

Congenital toxoplasmosis results from the transplacental transmission of the parasite Toxoplasma gondii after a maternal infection acquired in pregnancy. Prevalence of congenital infection ranges from 0.1 to 0.3 per 1000 live births. The maternal-fetal transmission rate increases with gestational age at maternal seroconversion, from less than 15% at 13 weeks of gestation to over 70% at 36 weeks. Conversely, the later the maternal infection, the lower the risk of symptomatic congenital infection (infections acquired during the third trimester are most often asymptomatic at birth). Prenatal diagnosis is currently performed by PCR analysis in amniotic fluid. Antenatal management and treatment vary considerably among countries. In some European countries, maternal infections are detected through serological screening allowing a prompt treatment with spiramycin, which is expected to reduce the risk of vertical transmission. If PCR analysis in amniotic fluid is positive or if maternal infection was acquired in the third trimester of pregnancy, a combination with pyrimethamine and sulphonamide is given until delivery. Benefits of antenatal treatments remain controversial. Infected newborns are prescribed pyrimethamine and sulphonamide for 12 months. Despite antenatal and postnatal treatment, chorioretinitis can occur at any age (prevalence>20% at 10 years of age): long-term ophthalmological follow-up remains necessary. Copyright © 2013 Elsevier B.V. All rights reserved.

Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT

International Nuclear Information System (INIS)

Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil

2010-01-01

The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) position emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

Cerebral Toxoplasmosis in a Patient with AIDS on F-18 FDG PET/CT

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Kim, Hae Won; Won, Kyung Sook; Choi, Byung Wook; Zeon, Seok Kil [Keimyung University School of Medicine, Daegu (Korea, Republic of)

2010-04-15

The distinction between primary central nervous system (CNS) lymphoma and nonmalignant lesions due to opportunistic infections, in particular cerebral toxoplasmosis, is important because of the different treatments involved. A 32-year-old patient with AIDS was hospitalized for intermittent headaches. Brain magnetic resonance imaging (MRI) showed a small well-enhanced nodular lesion in the right frontal lobe. A fluorine-18 fluorodeoxyglucose (F-18 FDG) position emission tomography (PET)/ computed tomography (CT) scan showed moderate FDG uptake in the nodular lesion of the right frontal lobe. We present a case of cerebral toxoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS) and the usefulness of F-18 FDG PET/CT in the differential diagnosis of the cerebral toxoplasmosis will be discussed.

Toxoplasmosis presented as a submental mass: a common disease, uncommon presentation.

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Li, Bo; Zou, Jian; Wang, Wei-Ya; Liu, Shi-Xi

2015-01-01

Submental mass secondary to toxoplasmosis is not common in clinical work. A diagnosis of toxoplasmosis is rarely considered by physicians. Here we describe a 50-year-old woman presented with a progressive, painful, submental and left neck swelling for 1 month. After having obtained an insufficient evidence from the fine-needle biopsy, the patient finally received an excisional biopsy which highly indicated the possibility of lymphadenopathy consistent with toxoplasmosis. Diagnosis of toxoplasmosis was finally established by a combination of the pathological criteria, together with the positive serological finding. According to review the clinical presentations, pathological characteristics, diagnostic standard and treatment of this disease, the article aims to remind otolaryngologists who are evaluating a neck mass should be aware of the infectious cause of lymphadenopathy and the possibility of toxoplasmosis.

Diagnosis of toxoplasmosis and typing of Toxoplasma gondii.

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Liu, Quan; Wang, Ze-Dong; Huang, Si-Yang; Zhu, Xing-Quan

2015-05-28

Toxoplasmosis, caused by the obligate intracellular protozoan Toxoplasma gondii, is an important zoonosis with medical and veterinary importance worldwide. The disease is mainly contracted by ingesting undercooked or raw meat containing viable tissue cysts, or by ingesting food or water contaminated with oocysts. The diagnosis and genetic characterization of T. gondii infection is crucial for the surveillance, prevention and control of toxoplasmosis. Traditional approaches for the diagnosis of toxoplasmosis include etiological, immunological and imaging techniques. Diagnosis of toxoplasmosis has been improved by the emergence of molecular technologies to amplify parasite nucleic acids. Among these, polymerase chain reaction (PCR)-based molecular techniques have been useful for the genetic characterization of T. gondii. Serotyping methods based on polymorphic polypeptides have the potential to become the choice for typing T. gondii in humans and animals. In this review, we summarize conventional non-DNA-based diagnostic methods, and the DNA-based molecular techniques for the diagnosis and genetic characterization of T. gondii. These techniques have provided foundations for further development of more effective and accurate detection of T. gondii infection. These advances will contribute to an improved understanding of the epidemiology, prevention and control of toxoplasmosis.

Toxoplasmosis and epilepsy--systematic review and meta analysis.

Science.gov (United States)

Ngoungou, Edgard B; Bhalla, Devender; Nzoghe, Amandine; Dardé, Marie-Laure; Preux, Pierre-Marie

2015-02-01

Toxoplasmosis is an important, widespread, parasitic infection caused by Toxoplasma gondii. The chronic infection in immunocompetent patients, usually considered as asymptomatic, is now suspected to be a risk factor for various neurological disorders, including epilepsy. We aimed to conduct a systematic review and meta-analysis of the available literature to estimate the risk of epilepsy due to toxoplasmosis. A systematic literature search was conducted of several databases and journals to identify studies published in English or French, without date restriction, which looked at toxoplasmosis (as exposure) and epilepsy (as disease) and met certain other inclusion criteria. The search was based on keywords and suitable combinations in English and French. Fixed and random effects models were used to determine odds ratios, and statistical significance was set at 5.0%. Six studies were identified, with an estimated total of 2888 subjects, of whom 1280 had epilepsy (477 positive for toxoplasmosis) and 1608 did not (503 positive for toxoplasmosis). The common odds ratio (calculated) by random effects model was 2.25 (95% CI 1.27-3.9), p = 0.005. Despite the limited number of studies, and a lack of high-quality data, toxoplasmosis should continue to be regarded as an epilepsy risk factor. More and better studies are needed to determine the real impact of this parasite on the occurrence of epilepsy.

Toxoplasmosis

DEFF Research Database (Denmark)

Petersen, Eskild

2007-01-01

an acute infection. The use of a Toxoplasma-specific IgG-avidity ratio, differentiated Western blots and two-dimensional immunoblots usually resolves diagnostic problems. There is no consensus on the best strategy to control congenital toxoplasmosis. Recent European prospective, but descriptive, studies...... in pregnant women and newborn children with congenital toxoplasmosis. Atovaquone is the most promising new drug available, but is not yet approved for use in pregnant women and small children. Udgivelsesdato: 2007-Jun...

Serological diagnosis of toxoplasmosis and standardization.

Science.gov (United States)

Zhang, Kuo; Lin, Guigao; Han, Yanxi; Li, Jinming

2016-10-01

Humans can be infected by the intracellular parasite Toxoplasma gondii, which causes toxoplasmosis, a common parasitic disease. Although the infection is generally asymptomatic for most adults, severe complications may occur in some individuals, especially women in early pregnancy. Serologic diagnosis is used as a routine practice to determine the immune status for infection by T. gondii. In this review, we attempt to provide an overview of the serological diagnosis of toxoplasmosis, including diagnostic strategy, current problems in detection with specific antibodies, and the standardization of T. gondii serological detection. Copyright © 2016 Elsevier B.V. All rights reserved.

Cerebral Toxoplasmosis in HIV/AIDS: A case report | Bedu-Addo ...

African Journals Online (AJOL)

This is a case of HIV infection with cerebral toxoplasmosis. Cerebral toxoplasmosis is an AIDS- related infection and is one of the causes of CNS mass lesions in AIDS. A 36-year-old male was admitted at Komfo Anokye Teaching Hospital (KATH) for a week. He had focal seizures for which he was treated as an “epileptic” ...

[Toxoplasmosis and cancer: Current knowledge and research perspectives].

Science.gov (United States)

Vittecoq, M; Thomas, F

2017-02-01

Toxoplasmosis, caused by Toxoplasma gondii, is one of the most prevalent parasitic diseases; it is estimated to affect a third of the world's human population. Many studies showed that latent toxoplasmosis may cause in some patients significant adverse effects including schizophrenia and bipolar disorders. In addition, two recent studies highlighted a positive correlation between the prevalence of brain tumors and that of T. gondii at national and international scale. These studies are correlative, thus they do not demonstrate a causal link between T. gondii and brain tumors. Yet, they call for further research that could shed light on the possible mechanisms underlying this association.

Toxoplasmosis in pregnancy: prevention, screening, and treatment.

Science.gov (United States)

Paquet, Caroline; Yudin, Mark H

2013-01-01

One of the major consequences of pregnant women becoming infected by Toxoplasma gondii is vertical transmission to the fetus. Although rare, congenital toxoplasmosis can cause severe neurological or ocular disease (leading to blindness), as well as cardiac and cerebral anomalies. Prenatal care must include education about prevention of toxoplasmosis. The low prevalence of the disease in the Canadian population and limitations in diagnosis and therapy limit the effectiveness of screening strategies. Therefore, routine screening is not currently recommended. To review the prevention, diagnosis, and management of toxoplasmosis in pregnancy. OUTCOMES evaluated include the effect of screening on diagnosis of congenital toxoplasmosis and the efficacy of prophylaxis and treatment. The Cochrane Library and Medline were searched for articles published in English from 1990 to the present related to toxoplasmosis and pregnancy. Additional articles were identified through references of these articles. The quality of evidence is rated and recommendations made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table). Guideline implementation should assist the practitioner in developing an approach to screening for and treatment of toxoplasmosis in pregnancy. Patients will benefit from appropriate management of this condition. The Society of Obstetricians and Gynaecologists of Canada. 1. Routine universal screening should not be performed for pregnant women at low risk. Serologic screening should be offered only to pregnant women considered to be at risk for primary Toxoplasma gondii infection. (II-3E) 2. Suspected recent infection in a pregnant woman should be confirmed before intervention by having samples tested at a toxoplasmosis reference laboratory, using tests that are as accurate as possible and correctly interpreted. (II-2B) 3. If acute infection is suspected, repeat testing should be performed within 2 to 3 weeks, and consideration

TREATMENT OF TOXOPLASMOSIS

Science.gov (United States)

Screening tests of various kinds of compounds were carried out with the purpose of obtaining new drugs for toxoplasmosis . Compounds tested were 66...Nitro-4’-formylamino-difenylsulfone might be effective in treatments of human toxoplasmosis . (Author)

Toxoplasmosis: Prevention and Control

Science.gov (United States)

... Toxoplasmosis FAQs Toxoplasmosis & Pregnancy FAQs Epidemiology & Risk Factors Biology Disease Diagnosis Treatment Prevention & Control Resources for Health Professionals Publications Printable Resources Additional ...

Estudio multicéntrico para la prevención de la toxoplasmosis prenatal en Buenos Aires Multicenter study on the prevention of congenital toxoplasmosis in Buenos Aires

Directory of Open Access Journals (Sweden)

Liliana Carral

2008-12-01

Full Text Available La toxoplasmosis es una infección causada por Toxoplasma gondii, parásito intracelular de distribución universal cuya tasa de seroprevalencia varía según la región. En el feto o recién nacido la infección causa morbilidad y mortalidad. El presente trabajo es una evaluación práctica de las propuestas del Consenso Argentino de Prevención de la Toxoplasmosis Prenatal. Participaron 9 hospitales de Buenos Aires y Conurbano donde se atendieron 19825 partos entre el 1º de mayo del 2006 y el 30 de abril del 2007. Se realizaron pruebas de tamizaje serológico en 13632 embarazadas con determinaciones de IgG e IgM por método de ELISA. La prevalencia de anticuerpos IgG específicos anti Toxoplasma gondii fue del 49%. Los sueros clasificados con criterio de infección reciente se remitieron al laboratorio del Hospital Alemán para ampliar el estudio. A los recién nacidos de estas madres se les efectuó control clínico y serológico. El análisis de los resultados de las 351 muestras enviadas confirmó que 121 (32% pacientes podrían haberse infectado durante el embarazo, en 176 (46% se descartó la infección reciente, en 37 embarazadas (10% la serología no fue concluyente y en 47 (12% faltó la fecha de gestación para su interpretación. Se efectuó control clínico y serológico a 94 recién nacidos de madres con infección durante el embarazo y se detectaron 5 toxoplasmosis congénitas con daño fetal, una microcefalia y cuatro coriorretinitis. El estudio permitió validar las guías y recomendaciones del Consenso Argentino de Toxoplasmosis Congénita.Toxoplasmosis is an infection caused by Toxoplasma gondii, an intracellular parasite of universal distribution, with a variable prevalence depending on the region. This infection causes both morbidity and mortality in the fetus and newborn. The present study is an evaluation of the Argentine Consensus Guidelines regarding prenatal prevention of toxoplasmosis. Screening tests in pregnant

Seroprevalence of Toxoplasmosis in Pregnant Women in Ilam Province, Iran

Directory of Open Access Journals (Sweden)

H Keshavarz

2008-04-01

Full Text Available Background: Toxoplasma gondii is an obligate intracellular protozoan parasite which can infect human and animals. Acquired toxoplasmosis during pregnancy can lead to fetal infection, which may ultimately result in loss of fetus or lesion in brain and eyes. This study was performed to evaluate the seroepidemiological status of toxoplasmosis in pregnant women in Ilam City, western Iran. Methods: In this cross-sectional study, 553 blood samples were collected from pregnant women. Sera were separated by blood centrifugation at 3000 rpm for 5 min and frozen at -20 °C until use. The samples were tested for IgG antibody by Indirect Immunoflourecence antibody test (IFA. Results: Out of the 553 pregnant women, 247 were positive for T. gondii IgG antibodies and 306 were negative. The mean age of women was 21 and the seropositive rate of latent T. gondii infection was 44.8%. Conclusion: About half of the married women in the present study were at risk of infection with T.gondii, so preventive method should be considered. Keywords: Seroepidemiology, Toxoplasmosis, IFA, Iran.

Prevalence and Risk Factors for Toxoplasmosis in Middle Java, Indonesia.

Science.gov (United States)

Retmanasari, Annisa; Widartono, Barandi Sapta; Wijayanti, Mahardika Agus; Artama, Wayan Tunas

2017-03-01

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii. Risk factors include consumption of undercooked meat, raw vegetables, and unfiltered water. This study aims to determine the seroprevalence and spatial distribution of toxoplasmosis in Middle Java, Indonesia, using an EcoHealth approach, combined with geographic information system (GIS). A total of 630 participants were randomly selected from seven districts. Each participant completed a questionnaire and provided a blood sample. The seroprevalence of toxoplasmosis was 62.5%. Of those who were seropositive, 90.1% were IgG+, and 9.9% were IgG+ and IgM+. Several risk factors were identified, including living at elevations of ≤200 m, compared with >200 m (OR = 56.2; P Java has a high prevalence of toxoplasmosis and identified some important environmental, ecological, and demographic risk factors. When researching diseases, such as toxoplasmosis, where animal hosts, human lifestyle, and environmental factors are involved in transmission, an EcoHealth method is essential to ensure a fully collaborative approach to developing interventions to reduce the risk of transmission in high-risk populations.

Spinal cord toxoplasmosis in AIDS

International Nuclear Information System (INIS)

Carteret, M.; Petit, E.; Granat, O.; Marichez, M.; Gilquin, J.

1995-01-01

Toxoplasmosis is the most common brain parasitic infection in acquired immunodeficiency syndrome (AIDS). Spinal cord localizations are still rare (2 cases with cerebral involvement, 2 cases without). A case of both spinal cord and cerebral involvement is reported. Magnetic resonance imaging (MR imaging) was performed because of sensory level (L 1). A focal conus medullaris enlargement was seen, iso intense on T 1 weighted images. This lesion was hyperintense on T 2 weighted sequence, and was homogeneously enhanced after Gadolinium on T 1 weighted images. A medullary oedema was noted. A toxoplasmosis treatment was initiated, without cortico therapy. MR imaging performed one month later (D 30), while important clinical improvements were seen, pointed out normal thickness of conus medullaris, without enhancement after Gadolinium. Disease lesions in AIDS with focal spinal cord processes are reviewed, and diagnostic work-up is discussed. Spinal cord single lesion, associated or not with brain involvements should be treated as a toxoplasmic infection, with MR imaging follow up. This work up should avoid medullary biopsy, still required in case of treatment failure. Cerebral involvements, with multiples lesions can mask medullary localization. (authors). 8 refs., 2 figs

Toxoplasmosis-Related Knowledge and Preventive Practices among Undergraduate Female Students in Jordan.

Science.gov (United States)

Al-Sheyab, Nihaya A; Obaidat, Mohammad M; Bani Salman, Alaa E; Lafi, Shawkat Q

2015-06-01

Foodborne toxoplasmosis is a leading cause of foodborne deaths and hospitalization worldwide. The level of exposure to Toxoplasma gondii is influenced by culture and eating habits. There is a scarcity of data about women's knowledge and perception of this disease. The aim of this study was to determine toxoplasmosis knowledge and preventive practices of young childbearing age women in Jordan. A descriptive cross-sectional study recruited a random sample of 1,390 undergraduate university female students and was stratified based on place of residency. About half of students (51.1%) reported having "ever" heard or read about toxoplasmosis, and almost all students (98.6%) had never been tested for toxoplasmosis. Overall, there was a lack of awareness about toxoplasmosis, its risk factors, symptoms, and timing of infection, and preventive practices. High percentages of females reported a high level of hygienic practices related to hand washing after gardening, changing cat litter, and handling raw meat. However, 16.7% of students reported eating raw meat, 26.5% usually eat traditional herbs, and 17.2% drink untreated spring water. This study establishes a baseline for the awareness levels about toxoplasmosis among young women in Jordan. These findings highlight the urgent need for toxoplasmosis awareness and preventive education for childbearing females. An effective education and outreach program should cover important topics concerning risk factors, high-risk foods, and preventive measures against toxoplasmosis.

Relationship between toxoplasmosis and schizophrenia: A review.

Science.gov (United States)

Fuglewicz, Aleksander J; Piotrowski, Patryk; Stodolak, Anna

2017-09-01

A growing body of evidence suggests a correlation between schizophrenia and exposure to infectious agents. The majority of studied cases concerns the infection caused by T. gondii, an obligatory intracellular parasite that infects about 1/3 of the entire human population, according to the available data. The acute stage of the disease, predominantly short-lived and transient, transforms into the latent and chronic phase in which the parasite localizes within tissue cysts, mainly in the central nervous system. The chronic toxoplasmosis, primarily regarded as benign and asymptomatic, might be responsible, in light of current scientific evidence, for a vast array of neuropsychiatric symptoms. Numerous epidemiological case-control studies show a higher prevalence of T. gondii infestation in individuals with various psychiatric and behavior disorders, including schizophrenia. This paper tends to review the relevant studies that demonstrate links between schizophrenia and T. gondii infestation, of which the latter may be acquired in different developmental phases. Apart from epidemiological correlation studies, some papers on other associations were also presented, describing putative patophysiological mechanisms that might be at least partly responsible for chronic infection-induced neuromediator disturbances, together with morphological and functional alterations, e.g., low-grade neuroinflammation, which are likely to induce psychopathological symptoms. Toxoplasmosis is only one of the putative infectious agents that derange correct brain growth and differentiation, alongside genetic and environmental factors. All of them may lead eventually to schizophrenia. A better knowledge of infection mechanisms and its influence on neurobiochemical and neuropathological pathways may enable more efficient therapy and the prevention of this devastating disease.

Seroprevalence of toxoplasmosis in antenatal women with bad obstetric history.

Science.gov (United States)

Chintapalli, Suryamani; Padmaja, I Jyothi

2013-01-01

The occurrence of fetal death is one of the tragedies that confront the physician providing obstetric care. Among the various agents associated with infections of pregnancy, viruses are the most important followed by bacteria and protozoa. Among protozoal infections in pregnancy, toxoplasmosis is reported to have a high incidence, sometimes causing fetal death. The study was intended to observe the seroprevalence of Toxoplasmosis in pregnant women presenting with bad obstetric history (BOH). A total of 92 antenatal women were included in the study (80 in the study group and 12 in control group). The study group comprised of antenatal women with BOH in the age group of 20-35 years. Antenatal women with Rh incompatibility, pregnancy induced hypertension, diabetes mellitus, renal disorders and syphilis were not included in the study. The control group included women in reproductive age group without BOH. All the samples were screened by enzyme linked immuno sorbent assay (ELISA) for Toxoplasma specific Immunoglobulin M (IgM) and Immunoglobulin G (IgG) antibodies. Of the 80 antenatal women in the study group, 36 (45%) were seropositive for Toxoplasma specific IgG antibodies (P habits, illiteracy, socio-economic status and residential status were also studied. We conclude that toxoplasmosis during pregnancy causes congenital fetal infection with possible fetal loss. ELISA was found to be a sensitive serological test for diagnosis of Toxoplasmosis in pregnant women with BOH. Major cause of fetal loss in BOH cases in the study group was abortion.

Toxoplasmosis and Toxocariasis: An Assessment of Human Immunodeficiency Virus Comorbidity and Health-Care Costs in Canada.

Science.gov (United States)

Schurer, Janna M; Rafferty, Ellen; Schwandt, Michael; Zeng, Wu; Farag, Marwa; Jenkins, Emily J

2016-07-06

Toxoplasma gondii and Toxocara spp. are zoonotic parasites with potentially severe long-term consequences for those infected. We estimated incidence and investigated distribution, risk factors, and costs associated with these parasites by examining hospital discharge abstracts submitted to the Canadian Institute for Health Information (2002-2011). Annual incidence of serious toxoplasmosis and toxocariasis was 0.257 (95% confidence interval [CI]: 0.254-0.260) and 0.010 (95% CI: 0.007-0.014) cases per 100,000 persons, respectively. Median annual health-care costs per serious case of congenital, adult-acquired, and human immunodeficiency virus (HIV)-associated toxoplasmosis were $1,971, $763, and $5,744, respectively, with an overall cost of C$1,686,860 annually (2015 Canadian dollars). However, the total economic burden of toxoplasmosis is likely much higher than these direct health-care cost estimates. HIV was reported as a comorbidity in 40% of toxoplasmosis cases and accounted for over half of direct health-care costs associated with clinical toxoplasmosis. A One Health approach, integrating physician and veterinary input, is recommended for increasing public awareness and decreasing the economic burden of these preventable zoonoses. © The American Society of Tropical Medicine and Hygiene.

P35 and P22 Toxoplasma gondii antigens abbreviate regions to diagnose acquired toxoplasmosis during pregnancy: toward single-sample assays.

Science.gov (United States)

Costa, Juan G; Peretti, Leandro E; García, Valeria S; Peverengo, Luz; González, Verónica D G; Gugliotta, Luis M; Dalla Fontana, Maria L; Lagier, Claudia M; Marcipar, Iván S

2017-03-01

P35 and P22 Toxoplasma gondii proteins are recognized by specific IgG at the early infection stage, making them ideal for acute toxoplasmosis pregnancy control. Both proteins have been studied to discriminate between acute and chronic toxoplasmosis. However, results were hardly comparable because different protein obtainment procedures led to different antigens, the reference panels used were not optimally typified, and avidity tests were either not performed or narrowly examined. We bioinformatically predicted P35 and P22 regions with the highest density of epitopes, and expressed them in pET32/BL21DE3 alternative expression system, obtaining the soluble proteins rP35a and rP22a. We assessed their diagnostic performance using pregnant woman serum samples typified as: not infected, NI (IgG-, IgM-), typical-chronic, TC (IgM-, IgG+), presumably acute, A (IgG+, IgM+, low-avidity IgG), and recently chronic, RC (IgG+, IgM+, high-avidity IgG). rP35a performed better than rP22a to differentiate A from RC, the areas under the curve (AUC) being 0.911 and 0.818, respectively. They, however, performed similarly to differentiate A from TC+RC (AUC: 0.915 and 0.907, respectively). rP35a and rP22a evaluation by avidity ELISA to discriminate A from RC rendered AUC values of 0.974 and 0.921, respectively. The indirect ELISA and avidity ELISA results analyzed in tandem were consistent with those obtained using commercial kits. rP35a and rP22a features suggest that, with complementary use, they could replace parasite lysate for toxoplasmosis infection screening and for acute toxoplasmosis diagnosis. Our proposal should be validated by a longitudinal study and may lead to a reliable toxoplasmosis pregnancy control, performing tests in only one serum sample.

Ultrasonic Diagnosis of Fetal Ascites and Toxoplasmosis

DEFF Research Database (Denmark)

Blaakær, Jan

1986-01-01

The ultrasonic diagnosis of fetal ascites caused by Toxoplasma Gondii is presented. When a diagnosis of fetal ascites without obvious etiological malformation is established, toxoplasmosis should be suspected. A serological test should be performed, in view of the possibility of antenatal treatme...

[Congenital toxoplasmosis: clinical manifestation, treatment and follow-up] [Article in Italian] • Il neonato con toxoplasmosi congenita: clinica, terapia e follow-up

Directory of Open Access Journals (Sweden)

Lina Bollani

2014-01-01

Full Text Available Toxoplamosis is a parasitic zoonosis which occurs worldwide, but is prevalent in Europe, South America and Africa. When infection occurs for the first time during pregnancy, mother to child transmission of the parasite can cause congenital toxoplasmosis. Rate of congenital infection ranges from less than 0.1 to approximately 1 per 1,000 live births. The risk of transmission depends on the gestational age at the time of maternal infection. A diagnosis of congenital toxoplasmosis is usually considered in infants who present: hydrocephalus, chorioretinitis, and intracranial calcifications, but this triade is very rare. Approximately 85% of the infants with congenital toxoplasmosis are clinically normal at birth; however, sequelae of infection may become apparent only months or even years later. Chorioretinitis is the main complication of congenital toxoplasmosis, late onset retinal lesions and relapse can appear many years after birth, but the overall ocular prognosis is satisfactory when infection is identified and treated accordingly. Fortunately, serious neonatal forms and severe neurological impairment have become rare, but prompt treatment of children with convulsions, abnormal muscle tone, hydrocephalus, may improve the prognosis and result in almost normal outcome. For infants who have congenital toxoplasmosis, treatment soon after birth for 1 year with pyrimetamine, sulfadiazine and leukoverin led to remarkable resolution of serious, active disease. A long follow-up is necessary to assess the long-term outcome of children and young adults with congenital toxoplasmosis, that is favourable for the majority of cases. Epidemiological surveillance needs to be improved in order to determine the effectiveness of prevention programs.Articoli Selezionati del “3° Convegno Pediatrico del Medio Campidano” · Guspini · 25 Maggio 2013Guest Editor: Roberto Antonucci

Sero-epidemiology of toxoplasmosis and associated risk factors among antenatal women in Ranchi, Jharkhand, India

OpenAIRE

Rana Pratap; Ahmad Nadeem Aslami; Manjushri; Narayan Prasad Sahu

2016-01-01

Background: Toxoplasmosis seroprevalence in antenatal women has remained a contentious issue in Indian subcontinent. Bad obstetric history (BOH) is specific to women of childbearing age and can be caused by infection with Toxoplama gondii. In Jharkhand, scarce data exist for the roles of toxoplasmosis in the aetiology of adverse pregnancy outcome. Aim: To study the sero-epidemiology of Toxoplasmosis and associated risk factors among antenatal women attending antenatal clinic of a tertiary car...

Assessment of ocular toxoplasmosis patients reported at a tertiary center in the northeast of Iran.

Science.gov (United States)

Hosseini, Seyedeh Maryam; Moghaddas, Elham; Sharifi, Karim; Dadgar Moghaddam, Malihe; Shamsian, Seyed Aliakbar

2018-01-15

Ocular toxoplasmosis, which is caused by the single-cell parasite Toxoplasma gondii, is currently the most significant cause of posterior uveitis in the world. No previous studies have described the prevalence and clinical features of ocular toxoplasmosis in the northeast of Iran. The purpose of the current study was to address this gap. In this retrospective study, the medical records of 488 uveitis patients who presented to the Khatam-al-Anbia Eye Hospital of Mashhad University of Medical Sciences, a tertiary ophthalmology center in the northeast of Iran, between January 2013 and December 2015 were evaluated. The clinical features and risk factors of 99 (20%) consecutive patients with ocular toxoplasmosis were extracted. Ninety-nine including 53 (53.5%) female and 46 (46.5%) male patients with ocular toxoplasmosis were included in the analysis. Reduced vision (77%) and floaters (15.2%) were the most common presenting symptoms. The age category that was most affected by ocular toxoplasmosis was 20-40 years (range: 11-65 years) with a mean age of 27.2. All patients had retinochoroiditis, but just two had anterior uveitis. All of the extracted patients, with the exception of three patients, had unilateral involvement. None of the patients had any other medical disorders with the exception of one woman, who had diabetes. Only four recurring ocular toxoplasmosis patients were referred to the education hospital during the study. Serology data were available for just 32 patients, of which 31 (96.8%) were IgG positive, and 1 (3.2%) was IgM positive. Toxoplasma gondii was responsible for 20% of the patients of uveitis that presented to the largest ophthalmology center in the northeast of Iran. There is a high incidence of patients of ocular toxoplasmosis in the northeast of Iran, and it is a significant cause of uveitis and visual impairment in this area.

201Tl brain SPECT in differentiating central nervous system lymphoma from toxoplasmosis in AIDS patients

International Nuclear Information System (INIS)

Kamata, Noriko; Suzuki, Kenzo; Abe, Katsumi; Yokoyama, Yoshiaki; Ushimi, Hisashi; Terada, Kazushi

1997-01-01

In AIDS patients, toxoplasmosis and lymphoma are the leading causes of CNS mass lesions. It is important to make the correct diagnosis expeditiously, since the two diseases require markedly different treatments and have different prognoses. In general, CT and MR imaging have failed to provide specific distinguishing characteristics to differentiate CNS lymphoma from toxoplasmosis, and it is difficult to differentiate these entities clinically. We performed 201 Tl brain SPECT in order to differentiate two diseases. Counts ratio of a lesion to the normal brain (L/N ratio) was elevated in patients of lymphoma compared in patients of toxoplasmosis. 201 Tl brain SPECT is useful to differentiate CNS lymphoma from toxoplasmosis. (author)

Incidence of death from congenital toxoplasmosis in 0-4-year-old children in Japan.

Science.gov (United States)

Hoshino, Tatsuji; Kita, Masato; Imai, Yukihiro; Yamakawa, Masaru

2014-08-01

Congenital toxoplasmosis is caused by Toxoplasma gondii. The incidence of death due to congenital toxoplasmosis in Japan from 1974 to 2007 was calculated using the autopsy database of the Japanese Society of Pathology and vital statistics from the Ministry of Health, Labour and Welfare. Two neonatal deaths due to congenital toxoplasmosis were reported during that time. As there were 161,195 neonatal deaths during this period and 32,465 autopsies were performed, the yearly neonatal death from congenital toxoplasmosis was calculated as 2 × 161,195/32,465/34 = 0.29 and the autopsy rate as 32,465/161,195 = 0.2014 (20.14%). The calculated number of annual deaths in infants was 0.82 and in children aged 1-4 years it was 2.09; thus, although few, deaths from congenital toxoplasmosis do still occur in neonates, infants, and young children. Therefore, obstetricians and pediatricians should be aware of the potential for congenital toxoplasmosis, and pregnant women should make every effort to avoid T. gondii infection. © 2014 Japan Pediatric Society.

Maternal and Congenital Toxoplasmosis, Currently Available and Novel Therapies in Horizon

Directory of Open Access Journals (Sweden)

Helieh S Oz

2014-07-01

Full Text Available Over one billion people worldwide are predicted to harbor Toxoplasma infection frequently with unknown lifelong health consequences. Toxoplasmosis is an important cause of foodborne, inflammatory illnesses, as well as congenital abnormalities. Ubiquitous Toxoplasma has a unique tropism for central nervous system with a mind bugging effect and is transmitted sexually through semen. Current available therapies are ineffective for persistent chronic disease and congenital toxoplasmosis or have severe side effects which may result in life threatening complications. There is an urgent need for safe and effective therapies to eliminate or treat this cosmopolitan infectious and inflammatory disease. This investigation will discuss pathogenesis of maternal and congenital toxoplasmosis, the current available therapies in practice, and the experimental therapeutic modalities for promising future trials.

Understanding Toxoplasmosis in the United States Through "Large Data" Analyses.

Science.gov (United States)

Lykins, Joseph; Wang, Kanix; Wheeler, Kelsey; Clouser, Fatima; Dixon, Ashtyn; El Bissati, Kamal; Zhou, Ying; Lyttle, Christopher; Rzhetsky, Andrey; McLeod, Rima

2016-08-15

Toxoplasma gondii infection causes substantial morbidity and mortality in the United States, and infects approximately one-third of persons globally. Clinical manifestations vary. Seropositivity is associated with neurologic diseases and malignancies. There are few objective data concerning US incidence and distribution of toxoplasmosis. Truven Health MarketScan Database and International Classification of Diseases, Ninth Revision (ICD-9) codes, including treatment specific to toxoplasmosis, identified patients with this disease. Spatiotemporal distribution and patterns of disease manifestation were analyzed. Comorbidities between patients and matched controls were compared. Between 2003 and 2012, 9260 patients had ICD-9 codes for toxoplasmosis. This database of patients with ICD-9 codes includes 15% of those in the United States, excluding patients with no or public insurance. Thus, assuming that demographics do not change incidence, the calculated total is 61 700 or 6856 patients per year. Disease was more prevalent in the South. Mean age at diagnosis was 37.5 ± 15.5 years; 2.4% were children aged 0-2 years, likely congenitally infected. Forty-one percent were male, and 73% of women were of reproductive age. Of identified patients, 38% had eye disease and 12% presented with other serious manifestations, including central nervous system and visceral organ damage. Toxoplasmosis was statistically associated with substantial comorbidities, including human immunodeficiency virus, autoimmune diseases, and neurologic diseases. Toxoplasmosis causes morbidity and mortality in the United States. Our analysis of private insurance records missed certain at-risk populations and revealed fewer cases of retinal disease than previously estimated, suggesting undercoding, underreporting, undertreating, or differing demographics of those with eye disease. Mandatory reporting of infection to health departments and gestational screening could improve care and facilitate detection of

Toxoplasmosis in a bar-shouldered dove (Geopelia humeralis) from the zoo of Clères, France

Science.gov (United States)

Toxoplasmosis causes mortality in several avian species, especially passerine birds. Toxoplasmosis was diagnosed in a bar-shouldered dove (Geopelia humeralis) found dead at the zoo of Clères (France). The bird had necrotizing pneumonia and nephritis with intralesional tachyzoites of Toxoplasma gondi...

CT and MR imaging evaluation of the inherited and prenatally acquired migrational disorders of the brain

International Nuclear Information System (INIS)

Byrd, S.E.; Osborn, R.E.; Naidich, T.P.; Bohan, T.P.

1987-01-01

The migrational disorders are a rare group of congenital malformations of the brain seen in children. They are primarily cortical and gray matter abnormalities. Forty patients, divided into two groups, were studied. In one group were patients with the classic migrational lesions of lissencephaly, pachygyria, schizencephaly, heterotopia, and polymicrogyria in which the underlying cause is genetic, chromosomal, or unknown. In the second group were patients with lesions caused by a prenatally acquired infection (toxoplasmosis or cytomegalic virus) or a metabolic abnormality. The CT and MR imaging findings in these two groups are discussed

Cerebral toxoplasmosis in AIDS

International Nuclear Information System (INIS)

Christ, F.; Steudel, H.; Klotz, D.; Bonn Univ.; Bonn Univ.

1986-01-01

Since 1982 (Hauser and co-workers), literature has reported focal cerebral tissue charges in AIDS patients whose diagnosis was unclear at first but which could be identified finally as florid toxoplasmosis encephalitis by biopsy and autopsy. It was found that the value of otherwise reliable serological tests (KBR, Sabin-Feldmann tests, etc.) is questionable in patients with severely impaired or incompetent immune systems, and, in particular, that a negative or uncharacteristic test result may not preclude any opportunistic infection process. Furthermore, isolation of Toxoplasma gondii or specific antibodies from the cerebrospinal fluid will be successful in exceptional cases only. In patients with AIDS or lymphadenopathy syndrome, the differential diagnosis will have to include - first and foremost - reactivated toxoplasma infection (not newly acquired, as a rule) if central neurological symptoms occur. (orig.) [de

Toxoplasmosis: a review | Efunshile | Nigerian Medical Practitioner

African Journals Online (AJOL)

Toxoplasmosis is caused by an obligate intracellular protozoan parasite, Toxoplasma gondii which is estimated to infect about a third of the human population. Infections have also been documented in more than 350 species of birds and mammals. Cats are the only definitive hosts. Infection is mostly a symptomatic in ...

Ocular sarcoidosis masked by positive IgM for toxoplasmosis

Directory of Open Access Journals (Sweden)

Murilo Bertazzo Peres

Full Text Available ABSTRACT We report a case of ocular sarcoidosis with positive immunoglobulin (Ig M and IgG serology for toxoplasmosis. The patient was a young female with red painful eyes, bilateral eyelid edema, and panuveitis with periphlebitis. In laboratory testing, she was IgM and IgG positive for toxoplasmosis and anergic in the tuberculin test. Topical treatment for anterior uveitis and oral antibiotics for toxoplasmosis were started, without improvement. Orbit tomography showed increased lacrimal glands bilaterally, and chest X-ray radiographic findings were consistent with pulmonary sarcoidosis, which supported the presumed ocular sarcoidosis diagnosis. The patient was treated with oral prednisone and methotrexate without antibiotics. She showed clinical and vision improvement without recurrences during the 1-year follow-up. Ocular sarcoidosis is an important differential diagnosis requiring careful anamnesis and ophthalmological examinations. Ancillary tests, such as X-ray radiography, tomography, and clinical and laboratory evaluations may help rule out other causes. Treatment mainly consists of corticosteroids and immunosuppression.

My Journey with Toxoplasmosis

Science.gov (United States)

Winter-Messiers, Mary Ann

2006-01-01

The author describes her fears and struggles as she came to terms, as an American expatriate in France, with a medical diagnosis of Toxoplasmosis. This condition led to her birthing a son with Asperger's Syndrome. She tells of plunging herself into research to learn more about Toxoplasmosis, the number of things that could be seriously wrong with…

Seroprevalence and risk factor of toxoplasmosis in schizophrenia ...

African Journals Online (AJOL)

Background: Toxoplasmosis is an infectious disease caused by protozoan parasite called Toxoplasma gondii. Toxoplasma gondii is an intracellular ... Human infection occurs mainly by ingesting food or water contaminated with oocyst or eating an undercook meat containing tissue cyst. Human might be infected via blood ...

Toxoplasmosis, an overview with emphasis on ocular involvement

NARCIS (Netherlands)

Klaren, Vincent N. A.; Kijlstra, Aize

2002-01-01

Toxoplasmosis is a common parasitic zoonosis and an important cause of abortions, mental retardation, encephalitis, blindness, and death worldwide. Although a large body of literature has emerged on the subject in the past decades, many questions about the pathogenesis and treatment of the disease

Review of toxoplasmosis in Malaysia.

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Yahaya, N

1991-12-01

Various studies on toxoplasmosis in Malaysia have shown that specific antibodies to Toxoplasma gondii are common among Malaysians. Among the ethnic groups, the Malays have the highest prevalence rate followed by Indians, Orang Aslis (aborigines) and Chinese. Antibody is acquired early in life and increases with age. There is no significant difference in the prevalence rate between males and females. The disease is apparently more prevalent among rural dwellers and those in the lower socioeconomic group. It appears that the prevalence rate is also influenced by environmental conditions, occupation, diet and cultural habits. Studies with animals have shown the presence of antibody to T. gondii, but this does not seem to be the source of infection since Malaysians normally cook their meat well.

Understanding Toxoplasmosis in the United States Through “Large Data” Analyses

Science.gov (United States)

Lykins, Joseph; Wang, Kanix; Wheeler, Kelsey; Clouser, Fatima; Dixon, Ashtyn; El Bissati, Kamal; Zhou, Ying; Lyttle, Christopher; Rzhetsky, Andrey; McLeod, Rima

2016-01-01

Background. Toxoplasma gondii infection causes substantial morbidity and mortality in the United States, and infects approximately one-third of persons globally. Clinical manifestations vary. Seropositivity is associated with neurologic diseases and malignancies. There are few objective data concerning US incidence and distribution of toxoplasmosis. Methods. Truven Health MarketScan Database and International Classification of Diseases, Ninth Revision (ICD-9) codes, including treatment specific to toxoplasmosis, identified patients with this disease. Spatiotemporal distribution and patterns of disease manifestation were analyzed. Comorbidities between patients and matched controls were compared. Results. Between 2003 and 2012, 9260 patients had ICD-9 codes for toxoplasmosis. This database of patients with ICD-9 codes includes 15% of those in the United States, excluding patients with no or public insurance. Thus, assuming that demographics do not change incidence, the calculated total is 61 700 or 6856 patients per year. Disease was more prevalent in the South. Mean age at diagnosis was 37.5 ± 15.5 years; 2.4% were children aged 0–2 years, likely congenitally infected. Forty-one percent were male, and 73% of women were of reproductive age. Of identified patients, 38% had eye disease and 12% presented with other serious manifestations, including central nervous system and visceral organ damage. Toxoplasmosis was statistically associated with substantial comorbidities, including human immunodeficiency virus, autoimmune diseases, and neurologic diseases. Conclusions. Toxoplasmosis causes morbidity and mortality in the United States. Our analysis of private insurance records missed certain at-risk populations and revealed fewer cases of retinal disease than previously estimated, suggesting undercoding, underreporting, undertreating, or differing demographics of those with eye disease. Mandatory reporting of infection to health departments and gestational

Toxoplasmosis

Science.gov (United States)

2011-06-01

gondii isolates; analysis of polymorphic sequences determines the precise type.58 If the patient is immunocom- petent, antibody titers should be... trimethoprim -sulfamethoxazole.64 Toxoplasmosis can be prevented by observing a few simple precautions. Because infection is most severe in the

Tc-99m colloid lung uptake in a rare case of toxoplasmosis with liver involvement

International Nuclear Information System (INIS)

Garty, I.; Tal, I.; Kaynan, A.

1984-01-01

Intensive lung accumulation of colloid (Tc-99m phytate) was demonstrated in a child suffering from acquired toxoplasmosis with a rare manifestation of severe liver damage. The possible mechanism and clinical importance of colloid lung concentration in this case is briefly discussed, including a review of the literature on this subject

Toxoplasmosis: An Important Message for Women

Science.gov (United States)

... health care provider if you have questions about toxoplasmosis. The best way to protect your unborn child is by protecting yourself against toxoplasmosis. • Wash your hands with soap and water after ...

Utility of the cytochrome c oxidase subunit I gene for the diagnosis of toxoplasmosis using PCR.

Science.gov (United States)

Feng, Xue; Norose, Kazumi; Li, Kexin; Hikosaka, Kenji

2017-10-01

Toxoplasmosis is caused by the protozoan parasite Toxoplasma gondii, which belongs to the phylum Apicomplexa. Since this parasite causes severe clinical symptoms in immunocompromised patients, early diagnosis of toxoplasmosis is essential. PCR is currently used for early diagnosis, but there is no consensus regarding the most effective method for amplifying Toxoplasma DNA. In this study, we considered the utility of the cytochrome c subunit I (cox1) gene, which is encoded in the mitochondrial DNA of this parasite, as a novel target of PCR for the diagnosis of toxoplasmosis. To do this, we compared its copy number per haploid nuclear genome and the detection sensitivity of cox1-PCR with the previously reported target genes B1 and 18S rRNA and the AF146527 repeat element. We found that the copy number of cox1 was high and that the PCR using cox1 primers was more efficient at amplifying Toxoplasma DNA than the other PCR targets examined. In addition, PCR using clinical samples indicated that the cox1 gene would be useful for the diagnosis of toxoplasmosis. These findings suggest that use of cox1-PCR would facilitate the diagnosis of toxoplasmosis in clinical laboratories. Copyright © 2017 Elsevier B.V. All rights reserved.

Seroepidemiology of toxoplasmosis in childbearing women of Northwest Iran.

Science.gov (United States)

Rajaii, Mehrangiz; Pourhassan, Aboulfazl; Asle-Rahnamaie-Akbari, Najibeh; Aghebati, Leili; Xie, Juliana Ling; Goldust, Mohammad; Naghavi-Behzad, Mohammad

2013-09-01

Toxoplasma gondii causes the most common parasitic infection in the world. Congenital transmission, prenatal mortality and abortion are major problems of T. gondii. Prevalence of toxoplasmosis is high in Iran, especially in Azerbaijan. The current literature reviewed in this paper reveal results pertaining to various regions of Iran. The present cross-sectional e-study was designed to evaluate the seroprevalence of toxoplasmosis in childbearing women in Northwest Iran. We evaluated 1659 women in childbearing age from several cities in Northwestern Iran (Tabriz, Maragheh, Ahar, Marand, Sarab, Miane) from July 2009 to August 2010. Women aged between 20 and 40 years and seeking prenatal care were enrolled in the study. The subjects' sera were probed with indirect fluorescent antibody (IFA). A total of 1659 subjects were examined. Titres ranged from 1:100 to 1:800. In all, 899 subjects (54.13%) were seropositive. The highest frequency of seropositivity was shown in 1:200 dilution (36.08%) and in subjects from Maragheh (84% of 211 subjects). There was a direct linear relationship between seropositivity and age (p 0.001). Also, seroprevalence of toxoplasmosis was higher in subjects with primary school/lower educational level (p 0.001) and subjects living in rural regions (p 0.001). Overall, more than 50% of women in childbearing age were seropositive for toxoplasmosis in northwestern Iran. Increasing seroprevalence of toxoplasmosis with age was a predictable result due to longer exposure to the parasite. The relationship between increasing seroprevalence and lower educational level as well as living in rural areas is in line with the latest epidemiological findings, which also show such relationships due to lower socioeconomic status.

CT manifestation of hepatic toxoplasmosis

International Nuclear Information System (INIS)

Mao Qing; Yang Yaying; Bao Yanming; He Bo; Wang Kechao; Song Guangyi; Lu Lin; Wang Xiaoli

2005-01-01

Objective: To study the CT manifestation of hepatic toxoplasmosis, and to provide image basis for its clinical diagnosis. Methods: Three patients with hepatic toxoplasmosis were examined by abdomen MSCT (pre- and post-contrast), and were confirmed by laboratory exams. The images were analyzed with information of clinical manifestation. Results: The positive appearances included the enlargement of liver, patches of multiple scattered low densities. Post-contrast lesions appearances: (1) No significant enhancement. (2) No significant occupying effection, and normal vessels inserting lesion occasionally. Conclusion: CT manifestation of hepar toxoplasmosis are some characteristic. But the diagnosis was made by a combination both clinical manifestation and laboratory exams. (authors)

On diagnosis of congenital toxoplasmosis

International Nuclear Information System (INIS)

Denisova, L.B.; Vorontsova, S.V.; Shvedov, V.A.

1999-01-01

Chemical manifestations are considered and CT-semiotics of congenital toxoplasmosis, which can form intracranial calcinates, is described. Taking a certain case of congenital toxoplasmosis observation as an example the potentialities and significance of X-ray computerized tomography (CT) in the identification of brain pathological changes are demonstrated. It is shown that intracranial calcificates may be a sign of toxoplasmosis infection. In case of cytomegalovirus infection the calcificates on CT-scans have mostly periventricular localization. Equally with the revealing of brain status in case of chronic stage of neutrotoxoplasmosis the CT has also played a decisive role in diagnosis of pseudotumoroseus course of ischemic insult [ru

Toxoplasmosis as a travel risk.

Science.gov (United States)

Sepúlveda-Arias, Juan C; Gómez-Marin, Jorge E; Bobić, Branko; Naranjo-Galvis, Carlos A; Djurković-Djaković, Olgica

2014-01-01

Toxoplasma gondii is a protozoan parasite with worldwide distribution that infects more than one third of the global population. Primary infection in immunocompetent individuals is usually asymptomatic; however, different organs can be affected in immunocompromised individuals leading to the development of encephalitis, myocarditis or pneumonitis. The prevalence of infection with Toxoplasma as well as its genetic structure varies geographically and for that reason travel may be considered as a risk factor to acquire the infection. As toxoplasmosis is a foodborne disease, health care providers should give health education on prevention measures to all prospective travelers in order to decrease the risk of infection in endemic areas. This review presents an overview of the infection with T. gondii with some considerations for travelers to and from endemic zones. Copyright © 2014 Elsevier Ltd. All rights reserved.

The disease burden of congenital toxoplasmosis in Denmark, 2014

DEFF Research Database (Denmark)

Nissen, Ioanna; Jokelainen, Pikka; Stensvold, Christen Rune

2017-01-01

Congenital toxoplasmosis (CT) causes a substantial disease burden worldwide. The aim of this study was to estimate the disease burden of CT in Denmark, a developed country with free public healthcare and nationwide data available. Using data primarily from two public health surveillance programmes...

Prenatal education for congenital toxoplasmosis.

Science.gov (United States)

Di Mario, Simona; Basevi, Vittorio; Gagliotti, Carlo; Spettoli, Daniela; Gori, Gianfranco; D'Amico, Roberto; Magrini, Nicola

2015-10-23

Congenital toxoplasmosis is considered a rare but potentially severe infection. Prenatal education about congenital toxoplasmosis could be the most efficient and least harmful intervention, yet its effectiveness is uncertain. To assess the effects of prenatal education for preventing congenital toxoplasmosis. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2015), and reference lists of relevant papers, reviews and websites. Randomized and quasi-randomized controlled trials of all types of prenatal education on toxoplasmosis infection during pregnancy. Cluster-randomized trials were eligible for inclusion. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. Two cluster-randomized controlled trials (RCTs) (involving a total of 5455 women) met the inclusion criteria. The two included trials measured the effectiveness of the intervention in different ways, which meant that meta-analysis of the results was not possible. The overall quality of the two studies, as assessed using the GRADE approach, was low, with high risk of detection and attrition bias in both included trials.One trial (432 women enrolled) conducted in Canada was judged of low methodological quality. This trial did not report on any of the review's pre-specified primary outcomes and the secondary outcomes reported results only as P values. Moreover, losses to follow-up were high (34%, 147 out of 432 women initially enrolled). The authors concluded that prenatal education can effectively change pregnant women's behavior as it increased pet, personal and food hygiene. The second trial conducted in France was also judged of low methodological quality. Losses to follow-up were also high (44.5%, 2233 out of 5023 women initially enrolled) and differential (40% in the intervention group and 52% in the control group). The authors concluded that prenatal education for congenital toxoplasmoses has a

Recurrent headache as the main symptom of acquired cerebral toxoplasmosis in nonhuman immunodeficiency virus-infected subjects with no lymphadenopathy: the parasite may be responsible for the neurogenic inflammation postulated as a cause of different types of headaches.

Science.gov (United States)

Prandota, Joseph

2007-01-01

Headache and/or migraine, a common problem in pediatrics and internal medicine, affect about 5% to 10% children and adolescents, and nearly 30% of middle-aged women. Headache is also one of the most common clinical manifestations of acquired Toxoplasma gondii infection of the central nervous system (CNS) in immunosuppressed subjects. We present 11 apparently nonhuman immunodeficiency virus-infected children aged 7 to 17 years (8 girls, 3 boys) and 1 adult woman with recurrent severe headaches in whom latent chronic CNS T. gondii infection not manifested by enlarged peripheral lymph nodes typical for toxoplasmosis, was found. In 7 patients, the mean serum IgG Toxoplasma antibodies concentration was 189 +/- 85 (SD) IU/mL (range 89 to 300 IU/mL), and in 5 other subjects, the indirect fluorescent antibody test titer ranged from 1:40 to 1:5120 IU/mL (n= metabolic pathways controlled by IDO being a significant contributor to the proinflammatory system. Also, it seems that idiopathic intracranial hypertension, pseudotumor cerebri, and aseptic meningitis, induced by various factors, may result from their interference with IDO and inducible nitric oxide synthase activities, endogenous NO level, and cytokine irregularities which finally affect former T. gondii status 2mo in the brain. All these biochemical disturbances caused by the CNS T. gondii infection/inflammation may also be responsible for the relationship found between neurologic symptoms, such as headache, vertigo, and syncope observed in apparently immunocompetent children and adolescents, and physical and psychiatric symptoms in adulthood. We therefore believe that tests for T. gondii should be performed obligatorily in apparently immunocompetent patients with different types of headaches, even if they have no enlarged peripheral lymph nodes. This may help to avoid overlooking this treatable cause of the CNS disease, markedly reduce costs of hospitalization, diagnosis and treatment, and eventually prevent

Cerebral toxoplasmosis in Danish AIDS patients

DEFF Research Database (Denmark)

Smith, E; Pers, C; Aschow, C

1991-01-01

We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring......-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had...... was 83% (10/12 patients) while among patients diagnosed in 1987 or earlier the accuracy was 41% (7/17 patients). Four patients were diagnosed with Pneumocystis carinii pneumonia (PCP) prior to the diagnosis of CNS toxoplasmosis, while among patients with toxoplasmosis as the AIDS-defining diagnosis, 3...

Toxoplasmosis - Awareness and knowledge among medical doctors in Nigeria.

Science.gov (United States)

Efunshile, Akinwale Michael; Elikwu, Charles John; Jokelainen, Pikka

2017-01-01

Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant.

Toxoplasmosis in wild and domestic animals

Science.gov (United States)

Toxoplasma gondii is widely distributed in wild and domestic animals. The present chapter reviews toxoplasmosis in wild and domestic animals. Coverage in wild animal species is limited to confirmed cases of toxoplasmosis, cases with parasite isolation, cases with parasite detection by PCR, and exper...

Cerebral toxoplasmosis in a diffuse large B cell lymphoma patient

International Nuclear Information System (INIS)

Savsek, Lina; Opaskar, Tanja Ros

2016-01-01

Toxoplasmosis is an opportunistic protozoal infection that has, until now, probably been an underestimated cause of encephalitis in patients with hematological malignancies, independent of stem cell or bone marrow transplant. T and B cell depleting regimens are probably an important risk factor for reactivation of a latent toxoplasma infection in these patients. We describe a 62-year-old HIV-negative right-handed Caucasian female with systemic diffuse large B cell lymphoma who presented with sudden onset of high fever, headache, altered mental status, ataxia and findings of pancytopenia, a few days after receiving her final, 8 th cycle of rituximab, cyclophosphamide, vincristine, doxorubicin, prednisolone (R-CHOP) chemotherapy regimen. A progression of lymphoma to the central nervous system was suspected. MRI of the head revealed multiple on T2 and fluid attenuated inversion recovery (FLAIR) hyperintense parenchymal lesions with mild surrounding edema, located in both cerebral and cerebellar hemispheres that demonstrated moderate gadolinium enhancement. The polymerase chain reaction on cerebrospinal fluid (CSF PCR) was positive for Toxoplasma gondii. The patient was diagnosed with toxoplasmic encephalitis and successfully treated with sulfadiazine, pyrimethamine and folic acid. Due to the need for maintenance therapy with rituximab for lymphoma remission, the patient now continues with secondary prophylaxis of toxoplasmosis. With this case report, we wish to emphasize the need to consider cerebral toxoplasmosis in patients with hematological malignancies on immunosuppressive therapy when presenting with new neurologic deficits. In such patients, there are numerous differential diagnoses for cerebral toxoplasmosis, and the CNS lymphoma is the most difficult among all to distinguish it from. If left untreated, cerebral toxoplasmosis has a high mortality rate; therefore early recognition and treatment are of essential importance

Toxoplasmosis--a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries.

Science.gov (United States)

Flegr, Jaroslav; Prandota, Joseph; Sovičková, Michaela; Israili, Zafar H

2014-01-01

Toxoplasmosis is becoming a global health hazard as it infects 30-50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this 'asymptomatic infection' may also lead to development of other human pathologies. The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries. Prevalence data published between 1995-2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (ptoxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and

Evaluation of Pregnant and Postpartum Women's Knowledge about Toxoplasmosis in Rio Grande - RS, Brazil.

Science.gov (United States)

Lehmann, Lis Maurente; Santos, Paula Costa; Scaini, Carlos James

2016-11-01

Introduction  Toxoplasmosis a parasitic zoonosis of global distribution, responsible for disorders during gestation can cause fetal death or congenital anomalies. Objective  To evaluate the knowledge of toxoplasmosis among pregnant and postpartum women treated at the University Hospital of the city of Rio Grande, Rio Grande do Sul, Brazil. Methods  This was a cross-sectional study of 100 pregnant and postpartum women at the University Hospital. Participants answered a self-administered questionnaire and gave consent for data relating to serological examinations to be abstracted from their medical records. Results  The proportion of women who received information about toxoplasmosis was higher among those who received care in the private health care system (52.9%) than among those cared for in the public health care system (25.0%). Only 55.7% of women reported having some knowledge about toxoplasmosis. Of these, 53.7% received information during the prenatal period. However, most participants were unable to answer questions about preventive measures and modes of infection. Of the 100 patients in the study, only 46 underwent serologic testing for toxoplasmosis, 65.2% of whom tested negative (IgG). Conclusion  Findings from this study are relevant to the training of health professionals regarding toxoplasmosis education and prevention. Improved education for health care providers and patients can lead to earlier diagnoses and reductions in adverse outcomes. Thieme Publicações Ltda Rio de Janeiro, Brazil.

Distal polyneuropathy in an adult Birman cat with toxoplasmosis

Directory of Open Access Journals (Sweden)

Lorenzo Mari

2016-02-01

Full Text Available Case summary A 6-year-old female spayed Birman cat presented with a history of weight loss, stiff and short-strided gait in the pelvic limbs and reluctance to jump, progressing to non-ambulatory tetraparesis over 6 weeks. Poor body condition, dehydration and generalised muscle wastage were evident on general examination. Neurological examination revealed mildly depressed mental status, non-ambulatory flaccid tetraparesis and severely decreased proprioception and spinal reflexes in all four limbs. The neuroanatomical localisation was to the peripheral nervous system. Haematology, feline immunodeficiency virus/feline leukaemia virus serology, serum biochemistry, including creatine kinase and thyroxine, thoracic radiographs and abdominal ultrasound did not reveal significant abnormalities. Electromyography revealed fibrillation potentials and positive sharp waves in axial and appendicular muscles. Decreased motor conduction velocities and compound muscle action potential amplitudes were detected in ulnar and sciatic–tibial nerves. Residual latency was increased in the sciatic–tibial nerve. Histologically, several intramuscular nerve branches were depleted of myelinated fibres and a few showed mononuclear infiltrations. Toxoplasma gondii serology titres were compatible with active toxoplasmosis. Four days after treatment initiation with oral clindamycin the cat recovered the ability to walk. T gondii serology titres and neurological examination were normal after 11 and 16 weeks, respectively. Clindamycin was discontinued after 16 weeks. One year after presentation the cat showed mild relapse of clinical signs and seroconversion, which again resolved following treatment with clindamycin. Relevance and novel information To our knowledge, this is the first report of distal polyneuropathy associated with toxoplasmosis in a cat. This case suggests the inclusion of toxoplasmosis as a possible differential diagnosis for acquired polyneuropathies in

Cerebral toxoplasmosis in a patient leads to diagnosis of AIDS

Directory of Open Access Journals (Sweden)

Alireza Soleimani

2015-08-01

Full Text Available Toxoplasmosis is an infection caused by the intracellular protozoan parasite, with a worldwide distribution from 30%–75% seroprevalence in different countries. In patient with immunosuppression such as AIDS, the parasite can be reactivated and causes the disease. We report on the case of a 36–year–old man admitted to MadaniHospital with Imbalance and loss of consciousness. He has been suffering headache, impaired speech and inability to walk since two weeks ago. In magnetic resonance imaging multiple space occupying lesions in bilateral cerebral hemispheres with ring enhancement after contrast injection were seen. HIV test for HIV-1 was reactive, Toxoplasma serology was revealed raised immunoglobulin G antibody levels of 650 IU/mL. Cerebral toxoplasmosis in this patient leads to diagnosis of HIV infection at advanced stage. The patient treated successfully with alternative drug but we need more activity in education of high risk people to get tested for HIV in our country, Iran.

Toxoplasmosis – A Global Threat. Correlation of Latent Toxoplasmosis with Specific Disease Burden in a Set of 88 Countries

Science.gov (United States)

Flegr, Jaroslav; Prandota, Joseph; Sovičková, Michaela; Israili, Zafar H.

2014-01-01

Background Toxoplasmosis is becoming a global health hazard as it infects 30–50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this ‘asymptomatic infection’ may also lead to development of other human pathologies. Aims of the Study The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries. Methods and Findings Prevalence data published between 1995–2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (ptoxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. Conclusions The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more

[Congenital toxoplasmosis: severe ocular and neurological complications

NARCIS (Netherlands)

Hoekstra, F.; Buzing, C.; Sporken, J.M.J.; Erasmus, C.E.; Flier, M. van der; Semmekrot, B.A.

2011-01-01

Two infants with congenital toxoplasmosis are presented. A girl born prematurely was treated postnatally after the mother had received antimicrobial treatment during pregnancy for acute toxoplasmosis. Apart from being small for gestational age, she remained without symptoms and treatment was ceased

MR findings of central nervous system involvement in acquired immunodeficiency syndrome patient : a report of two cases

International Nuclear Information System (INIS)

Hong, Hye Suk; Kim, Dong Ik; Lee, Byeong Hee; Jeong, Sun Yang

1996-01-01

Central nervous system (CNS) manifestations in acquired immunodeficiency syndrome (AIDS) patients are an early and common feature. The spectrum of AIDS-related CNS diseases are encephalitis caused by the human immunodeficiency virus(HIV) itself, opportunistic infection, infarct and malignancy. We experienced two cases of CNS involvement in AIDS and they were serologically diagnosed as HIV encephalitis and CNS toxoplasmosis, respectively. In the case of the HIV encephalitis patient, brain MRI showed a non-enhancing lesion with high signal intensity on T2WI and low signal on T1WI and there was no mass effect on the right frontal lobe, periventricular white matter, splenium of the corpus callosum or bilateral basal ganglia. In the other case of CNS toxoplasmosis, MR showed multiple nodular and rim enhanced mass lesions in the right basal ganglia, thalamus and periventricular white matter, which were of low signal intensity on T1WI and of high intensity on T2WI. We thus report the related MRI findings

Toxoplasmosis Complications and Novel Therapeutic Synergism Combination of Diclazuril plus Atovaquone

Directory of Open Access Journals (Sweden)

Helieh S Oz

2014-09-01

Full Text Available Toxoplasmosis is a major cause of foodborne disease, congenital complication and morbidity. There is an urgent need for safe and effective therapies to encounter congenital and persisting toxoplasmosis. The hypothesis was: Combination Diclazuril plus Atovaquone to exert a novel therapeutic synergy to prevent toxoplasmosis syndromes. Methods. Pregnant dams were treated with Diclazuril and Atovaquone monotherapy or combination therapy and infected intraperitoneally with Toxoplasma tachyzoites (600. Results. Infected dams developed severe toxoplasmosis associated syndrome with increases in the abdominal adiposity surrounding uteri, gansterointestinal and other internal organs and excessive weight gain. Numerous organisms along with infiltration of inflammatory cells were detected scattered into adipose tissues. Combination therapy (p< 0.01 and to a lesser extent Diclazuril (p< 0.05 protected dams from inflammatory fat and excess weight gains. This was consistent with pancreatitis development in infected dams (versus normal p< 0.05 with infiltration of inflammatory cells, degeneration and necrosis of pancreatic cells followed by the degeneration and loss of islets. Combination and monotherapy protected dams from these inflammatory and pathological aspects of pancreatitis. Infected dams exhibited severe colitis, and colonic tissues significantly shortened in length. Brush border epithelial cells were replaced with infiltration of lymphocytes, granulocytes, and microabscess formations into cryptic microstructures. Combination therapy synergistically preserved colonic structure and normalized pathological damages (p< 0.001 and to a lesser degree Diclazuril monotherapy protected dams from colitis (p< 0.05 and gastrointestinal toxoplasmosis. Other complications included severe splenitis (p<0.001 and hepatitis (p<0.001 which were normalized with combination therapy. Conclusions. Combination Diclazuril plus Atovaquone was safe and with a novel therapeutic

[Retrospective study of the implementation of the qualitative PCR technique in biological samples for monitoring toxoplasmosis in pediatric patients receiving hematopoietic stem cell transplantation].

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Nigro, Mónica G; Figueroa, Carlos; Ledesma, Bibiana A

2014-01-01

Toxoplasmosis is an opportunistic infection caused by the parasite Toxoplasma gondii. The infection is severe and difficult to diagnose in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Twelve patients receiving HSCT were monitored post-transplant, by qualitative PCR at the Children's Hospital S.A.M.I.C. "Prof. Dr. Juan P. Garrahan". The monitoring of these patients was defined by a history of positive serology for toxoplasmosis in the donor or recipient and because their hematologic condition did not allow the use of trimethoprim-sulfamethoxazole for prophylaxis. During the patients' monitoring, two of them with positive PCR results showed signs of illness by T. gondii and were treated with pyrimethamine-clindamycin. In two other patients, toxoplasmosis was the cause of death and an autopsy finding, showing negative PCR results. Four patients without clinical manifestations received treatment for toxoplasmosis because of positive PCR detection. In four patients there were no signs of toxoplasmosis disease and negative PCR results during follow-up. The qualitative PCR technique proved useful for the detection of toxoplasmosis reactivation in HSCT recipients, but has limitations in monitoring and making clinical decisions due to the persistence of positive PCR over time and manifestations of toxicity caused by the treatment. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España. All rights reserved.

Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study

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Malý Marek

2002-07-01

Full Text Available Abstract Background The parasite Toxoplasma gondii infects 30–60% of humans worldwide. Latent toxoplasmosis, i.e., the life-long presence of Toxoplasma cysts in neural and muscular tissues, leads to prolongation of reaction times in infected subjects. It is not known, however, whether the changes observed in the laboratory influence the performance of subjects in real-life situations. Methods The seroprevalence of latent toxoplasmosis in subjects involved in traffic accidents (N = 146 and in the general population living in the same area (N = 446 was compared by a Mantel-Haenszel test for age-stratified data. Correlation between relative risk of traffic accidents and level of anti-Toxoplasma antibody titre was evaluated with the Cochran-Armitage test for trends. Results A higher seroprevalence was found in the traffic accident set than in the general population (Chi2MH = 21.45, p 95= 1.76–4.01 times higher risk of an accident than the toxoplasmosis-negative subjects. The OR significantly increased with level of anti-Toxoplasma antibody titre (p 95 = 1.14–3.03 for the 99 subjects with low antibody titres (8 and 16, higher (OR = 4.78, C.I.95 = 2.39–9.59 for the 37 subjects with moderate titres (32 and 64, and very high (OR = 16.03, C.I.95 = 1.89–135.66 for the 6 subjects with titres higher than 64. Conclusion The subjects with latent toxoplasmosis have significantly increased risk of traffic accidents than the noninfected subjects. Relative risk of traffic accidents decreases with the duration of infection. These results suggest that 'asymptomatic' acquired toxoplasmosis might in fact represent a serious and highly underestimated public health problem, as well as an economic problem.

Cogenital toxoplasmosis

International Nuclear Information System (INIS)

Dusser, A.; Diebler, C.; Dulac, O.

1985-01-01

The purpose of the paper is to assess the clinical and neuroradiological signs of congenital toxoplasmosis, to correlate these signs with the date of maternal infection and to discuss the efficacy of preventive maternal treatment on the basis of 31 personal observations. (orig./MG)

Connectionist neuropsychology: uncovering ultimate causes of acquired dyslexia.

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Woollams, Anna M

2014-01-01

Acquired dyslexia offers a unique window on to the nature of the cognitive and neural architecture supporting skilled reading. This paper provides an integrative overview of recent empirical and computational work on acquired dyslexia within the context of the primary systems framework as implemented in connectionist neuropsychological models. This view proposes that damage to general visual, phonological or semantic processing abilities are the root causes of different forms of acquired dyslexia. Recent case-series behavioural evidence concerning pure alexia, phonological dyslexia and surface dyslexia that supports this perspective is presented. Lesion simulations of these findings within connectionist models of reading demonstrate the viability of this approach. The commitment of such models to learnt representations allows them to capture key aspects of performance in each type of acquired dyslexia, particularly the associated non-reading deficits, the role of relearning and the influence of individual differences in the premorbid state of the reading system. Identification of these factors not only advances our understanding of acquired dyslexia and the mechanisms of normal reading but they are also relevant to the complex interactions underpinning developmental reading disorders.

New antibacterials for the treatment of toxoplasmosis; a patent review.

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Rodriguez, Juan Bautista; Szajnman, Sergio Hernán

2012-03-01

Toxoplasma gondii is an opportunistic protozoan parasite responsible for toxoplasmosis. T. gondii is able to infect a wide range of hosts, particularly humans and warm-blooded animals. Toxoplasmosis can be considered as one of the most prevalent parasitic diseases affecting close to one billion people worldwide, but its current chemotherapy is still deficient and is only effective in the acute phase of the disease. This review covers different approaches to toxoplasmosis chemotherapy focused on the metabolic differences between the host and the parasite. Selective action on different targets such as the isoprenoid pathway, dihydrofolate reductase, T. gondii adenosine kinase, different antibacterials, T. gondii histone deacetylase and calcium-dependent protein kinases is discussed. A new and safe chemotherapy is needed, as T. gondii causes serious morbidity and mortality in pregnant women and immunodeficient patients undergoing chemotherapy. A particular drawback of the available treatments is the lack of efficacy against the tissue cyst of the parasite. During this review a broad scope of several attractive targets for drug design have been presented. In this context, the isoprenoid pathway, dihydrofolate reductase, T. gondii histone deacetylase are promising molecular targets.

Molecular diagnosis of toxoplasmosis in immunocompromised patients.

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Robert-Gangneux, Florence; Belaz, Sorya

2016-08-01

Toxoplasmosis in immunocompromised patients is associated with a high mortality rate. Molecular techniques are important tools to diagnose acute disease in immunocompromised patients, but there are various methods with variable efficiency. Some of them have been validated for the diagnosis of congenital toxoplasmosis, but the impact of their use has not been evaluated in immunocompromised patients. Toxoplasmosis is of increasing importance in non-HIV immunocompromised patients. In addition, the picture of disease shows greater severity in South America, both in immunocompetent study participants and in congenitally infected infants. These epidemiological differences could influence the sensitivity of diagnostic methods. This review analyzes recent data on molecular diagnosis and compares them with older ones, in light of progress gained in molecular techniques and of recent epidemiological findings. Most recent studies were conducted in South America and used PCR targeting the B1 gene. PCR on blood could allow diagnosing a significant proportion of patients with ocular toxoplasmosis in Brazil. Quantitative PCR methods with specific probes should be used to improve sensitivity and warrant specificity. Performance of quantitative PCR targeting the repeated 529 bp sequence for the diagnosis of toxoplasmosis in immunocompromised patients needs evaluation in field studies in South America and in western countries.

Assessment of laboratory methods used in the diagnosis of congenital toxoplasmosis after maternal treatment with spiramycin in pregnancy

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2014-01-01

Background The different laboratory methods used in the diagnosis of congenital toxoplasmosis have variable sensitivity and specificity. There is no evidence to prove that maternal treatment reduces the risk of fetal infection. The purpose of this study was to assess methods for the confirmation of congenital toxoplasmosis after maternal treatment with spiramycin during pregnancy, and to evaluate the effect of this treatment on clinical manifestations of the disease in newborns (NB). Methods This was a community-based, cross-sectional study of acute toxoplasmosis in newborns at risk of acquiring congenital infection. Participating newborns were born in the Clinical Hospital Maternity Ward of the Federal University of Goiás. Eligible participants were divided into 2 groups: group 1 consisted of 44 newborns born to mothers treated with spiramycin during pregnancy and group 2 consisted of 24 newborns born to mothers not treated with spiramycin during pregnancy because the diagnosis of toxoplasmosis was not performed. The sensitivity and specifity of PCR for T. gondii DNA in peripheral blood and serological testing for specific anti-T. gondii IgM and IgA, and the effects of maternal spiramycin treatment on these parameters, were determined by associating test results with clinical manifestations of disease. Results The sensitivity of the markers (T. gondii DNA detected by PCR, and the presence of specific anti-T. gondii IgM and IgA) for congenital toxoplasmosis was higher in group 2 than in group 1 (31.6, 68.4, 36.8% and 3.7, 25.9, 11.1% respectively). Even with a low PCR sensitivity, the group 2 results indicate the importance of developing new techniques for the diagnosis of congenital toxoplasmosis in newborns. Within group 1, 70.4% of the infected newborns were asymptomatic and, in group 2, 68.4% showed clinical manifestations of congenital toxoplasmosis. Conclusions The higher proportion of infants without clinical symptoms in group 1 (70.4%) suggests the

Toxoplasmosis in Tammar wallabies (Macropus eugenii) in the Budapest Zoo and Botanical Garden (2006-2010).

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Sós, Endre; Szigeti, Alexandra; Fok, Eva; Molnár, Viktor; Erdélyi, Károly; Perge, Edina; Biksi, Imre; Gál, János

2012-09-01

Smaller macropodid species (commonly referred to as wallabies) are extremely susceptible to toxoplasmosis: in most cases, infection with Toxoplasma gondii leads to death within a short time. Between June 2006 and July 2010, T. gondii was detected by immunohistochemical examination in six Tammar wallabies (Macropus eugenii) that died in the Budapest Zoo and Botanical Garden; in another four specimens histopathology revealed T. gondii-like organisms (which could not be differentiated from Neospora caninum solely by morphology), and in another 11 animals toxoplasmosis as the possible cause of death could not be excluded. The current zoo population of 12 Tammar wallabies was tested for T. gondii IgG antibodies by the modified agglutination test (MAT), with negative results. We suppose that most of the deaths were due to acute toxoplasmosis resulting from a recent infection.

Review of toxoplasmosis in Morocco: seroprevalence and risk factors for toxoplasma infection among pregnant women and HIV- infected patients.

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Laboudi, Majda

2017-01-01

Toxoplasmosis is a disease caused by a protozoal parasite: Toxoplasma gondii . This infection can cause severe illness when the organism is contracted congenitally or when it is reactivated in immunosuppressed people. In this paper we review for the first time prevalence and risk factors of T. gondii among pregnant women and HIV-infected adults in Morocco. A systematic review methodology was used to consult three databases: Pub Med, Science Direct and Google Scholar dated until 2015, regarding prevalence data and risk factors of infection among pregnant women and people living with HIV. Data collection and eligibility criteria were established in this paper. No statistical method was employed in this study. Our review resulted in a total of 6 publications meeting the inclusion criteria of prevalence and risk factors of toxoplasmosis in Morocco. Seropositive rates of T. gondii infection reach up to 51% in pregnant women. Risk factors that were reported included contact with soil, lack of knowledge about toxoplasmosis, and a low educational level. For HIV-infected adults, the limited data show a 62.1% prevalence rate of T. gondii .According to our review, there is still very little information on toxoplasmosis disease in pregnant women and HIV infected patients in Morocco. Further research on toxoplasmosis is needed to better ascertain the human disease burden in Morocco.

Characterization of ROP18 alleles in human toxoplasmosis.

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Sánchez, Víctor; de-la-Torre, Alejandra; Gómez-Marín, Jorge Enrique

2014-04-01

The role of the virulent gene ROP18 polymorphisms is not known in human toxoplasmosis. A total of 320 clinical samples were analyzed. In samples positive for ROP18 gene, we determined by an allele specific PCR, if patients got the upstream insertion positive ROP18 sequence Toxoplasma strain (mouse avirulent strain) or the upstream insertion negative ROP18 sequence Toxoplasma strain (mouse virulent strain). We designed an ELISA assay for antibodies against ROP18 derived peptides from the three major clonal lineages of Toxoplasma. 20 clinical samples were of quality for ROP18 allele analysis. In patients with ocular toxoplasmosis, a higher inflammatory reaction on eye was associated to a PCR negative result for the upstream region of ROP18. 23.3%, 33% and 16.6% of serums from individuals with ocular toxoplasmosis were positive for type I, type II and type III ROP18 derived peptides, respectively but this assay was affected by cross reaction. The absence of Toxoplasma ROP18 promoter insertion sequence in ocular toxoplasmosis was correlated with severe ocular inflammatory response. Determination of antibodies against ROP18 protein was not useful for serotyping in human toxoplasmosis. © 2013.

Toxoplasmosis among pregnant women attending antenatal clinic in ...

African Journals Online (AJOL)

Toxoplasmosis is a neglected tropical protozoan disease of public health importance. This study estimated the seroprevalence of toxoplasmosis and the associated risk factors among pregnant women attending the antenatal clinic in the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria. Two hundred and ...

Toxoplasmosis in Blood Donors: A Systematic Review and Meta-Analysis.

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Foroutan-Rad, Masoud; Majidiani, Hamidreza; Dalvand, Sahar; Daryani, Ahmad; Kooti, Wesam; Saki, Jasem; Hedayati-Rad, Faezeh; Ahmadpour, Ehsan

2016-07-01

Transfusion-transmissible infections include pathogens that may cause severe and debilitating diseases. Toxoplasmosis is a cosmopolitan neglected parasitic infection that can lead to severe complications including death in immune-compromised patients or following infection in utero. Multiple studies have demonstrated the transmission of Toxoplasma gondii by blood transfusion. The objective of this review was to comprehensively assess the seroprevalence rate of Toxoplasma in blood donors from a worldwide perspective. Seven electronic databases (PubMed, Science Direct, Web of Science, Scopus, Cochrane, Ovid, and Google Scholar) were searched using medical subject headings terms. A total of 43 records met the inclusion criteria in which 20,964 donors were tested during the period from January 1980 to June 2015. The overall weighted prevalence of exposure to toxoplasmosis in blood donors was 33% (95% confidence interval [CI], 28%-39%). The seroprevalences of immunoglobulin (Ig)M and both IgG and IgM antibodies were 1.8% (95% CI, 1.1%-2.4%) and 1.1% (95% CI, 0.3%-1.8%), respectively. The highest and the lowest seroprevalences of toxoplasmosis were observed in Africa (46%; 95% CI, 14%-78%) and in Asia (29%; 95% CI, 23%-35%), respectively. Brazil (75%) and Ethiopia (73%) were identified as countries with high seroprevalence. Because positive serology does not imply infectiousness and because seroprevalence is high in some nations, a positive serology test result alone cannot be used as an effective method for donor screening. Future research for methods to prevent transfusion-transmitted toxoplasmosis may derive benefit from studies conducted in areas of high endemicity. Copyright © 2016 Elsevier Inc. All rights reserved.

An enzyme-linked immuno-filtration assay used to compare infant and maternal antibody profiles in toxoplasmosis.

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Pinon, J M; Thoannes, H; Gruson, N

1985-02-28

Enzyme-linked immuno-filtration assay is carried out on a micropore membrane. This doubly analytical technique permits simultaneous study of antibody specificity by immunoprecipitation and characterisation of antibody isotypes by immuno-filtration with enzyme-labelled antibodies. Recognition of the same T. gondii antigenic constituent by IgG, IgA, IgM or IgE antibodies produces couplets (IgG-IgM; IgG-IgA) or triplets (IgG-IgM-IgA; IgG-IgM-IgE) which identify the functional fractions of the toxoplasmosis antigen. In acquired toxoplasmosis, the persistence of IgM antibody long after infestation puts in question the implication of recent infestation normally linked to detection of this isotype. For sera of comparable titres, comparison of immunological profiles by the method described demonstrates disparities in the composition of the specific antibody content as expressed in international units. Use of the same method to detect IgM antibodies or distinguish between transmitted maternal IgG and IgG antibodies synthesised by the foetus or neonate makes a diagnosis of congenital toxoplasmosis possible in 85% of cases during the first few days of life. With the method described the diagnosis may be made on average 5 months earlier than with classical techniques. In the course of surveillance for latent congenital toxoplasmosis, the appearance of IgM or IgE antibodies raises the possibility of complications (hydrocephalus, chorioretinitis). After cessation of treatment, a rise in IgG antibodies indicating persistence of infection is detected earlier by the present than by classical methods.

Clinical aspects of toxoplasmosis in small animal

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André Luiz Baptista Galvão

2014-02-01

Full Text Available Toxoplasmosis, a zoonosis of worldwide distribution, has importance in human and veterinary medicine. Animals can be direct or indirect source of infection to man, and this intermediate host, the disease may be responsible for encephalitis and deaths due to congenital form as coinfection in neonates and patients with acquired immunodeficiency syndrome. The man and animals can acquire the disease by eating undercooked meat or cures, infected with tissue cysts, as well as food and water contaminated with oocysts. Iatrogenic, such as, blood transfusion and organ transplantation are other less frequent routes of transmission. The causative agent of this disease is Toxoplasma gondii, a protozoan obligate intracellular coccidian. In small animals, the infection has been reported in several countries, promoting varied clinical manifestations and uncommon but severe and fatal, which is a challenge in the clinical diagnosis of small animals, especially when the nervous system involvement. Thus, constitute the purpose of this review address the participation of small animals in the spread of the disease, clinical aspects related to it, as well as discuss methods of diagnosis, therapeutic measures, prophylaxis and control of this disease.

Genetic Polymorphisms in Cytokine Genes in Colombian Patients with Ocular Toxoplasmosis.

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Naranjo-Galvis, C A; de-la-Torre, A; Mantilla-Muriel, L E; Beltrán-Angarita, L; Elcoroaristizabal-Martín, X; McLeod, R; Alliey-Rodriguez, N; Begeman, I J; López de Mesa, C; Gómez-Marín, J E; Sepúlveda-Arias, J C

2018-04-01

Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii , which has the capacity to infect all warm-blooded animals worldwide. Toxoplasmosis is a major cause of visual defects in the Colombian population; however, the association between genetic polymorphisms in cytokine genes and susceptibility to ocular toxoplasmosis has not been studied in this population. This work evaluates the associations between polymorphisms in genes coding for the cytokines tumor necrosis factor alpha (TNF-α) (rs1799964, rs1800629, rs1799724, rs1800630, and rs361525), interleukin 1β (IL-1β) (rs16944, rs1143634, and rs1143627), IL-1α (rs1800587), gamma interferon (IFN-γ) (rs2430561), and IL-10 (rs1800896 and rs1800871) and the presence of ocular toxoplasmosis (OT) in a sample of a Colombian population (61 patients with OT and 116 healthy controls). Genotyping was performed with the "dideoxynucleotide (ddNTP) primer extension" technique. Functional-effect predictions of single nucleotide polymorphisms (SNPs) were done by using FuncPred. A polymorphism in the IL-10 gene promoter (-1082G/A) was significantly more prevalent in OT patients than in controls ( P = 1.93e-08; odds ratio [OR] = 5.27e+03; 95% confidence interval [CI] = 3.18 to 8.739; Bonferroni correction [BONF] = 3.48e-07). In contrast, haplotype "AG" of the IL-10 gene promoter polymorphisms (rs1800896 and rs1800871) was present at a lower frequency in OT patients ( P = 7e-04; OR = 0.10; 95% CI = 0.03 to 0.35). The +874A/T polymorphism of IFN-γ was associated with OT ( P = 3.37e-05; OR = 4.2; 95% CI = 2.478 to 7.12; BONF = 6.07e-04). Haplotype "GAG" of the IL-1β gene promoter polymorphisms (rs1143634, rs1143627, and rs16944) appeared to be significantly associated with OT ( P = 0.0494). The IL-10, IFN-γ, and IL-1β polymorphisms influence the development of OT in the Colombian population. Copyright © 2018 American Society for Microbiology.

[Toxoplasmosis and Pregnancy: Reliability of Internet Sources of Information].

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Bobić, Branko; Štajner, Tijana; Nikolić, Aleksandra; Klun, Ivana; Srbljanović, Jelena; Djurković-Djaković, Olgica

2015-01-01

Health education of women of childbearing age has been shown to be an acceptable approach to the prevention of toxoplasmosis, the most frequent congenitally transmitted parasitic infection. The aim of this study was to evaluate the Internet as a source of health education on toxoplasmosis in pregnancy. A group of 100 pregnant women examined in the National Reference Laboratory for Toxoplasmosis was surveyed by a questionnaire on the source of their information on toxoplasmosis. We also analyzed information offered by websites in the Serbian and Croatian languages through the Google search engine, using "toxoplasmosis" as a keyword. The 23 top websites were evaluated for comprehensiveness and accuracy of information on the impact of toxoplasmosis on the course of pregnancy, diagnosis and prevention. Having knowledge on toxoplasmosis was confirmed by 64 (64.0%) examined women, 40.6% (26/64) of whom learned about toxoplasmosis through the Internet, 48.4% from physicians, and 10.9% from friends. Increase in the degree of education was found to be associated with the probability that pregnant women would be informed via the Internet (RR=3.15, 95% CI=1.27-7.82, p=0.013). Analysis of four interactive websites (allowing users to ask questions) showed that routes of infection were the most common concern, particularly the risk presented by pet cats and dogs, followed by the diagnosis of infection (who and when should be tested, and how should the results be interpreted). Of 20 sites containing educational articles, only seven were authorized and two listed sources. Evaluation confirmed that information relevant to pregnant women was significantly more accurate than comprehensive, but no site gave both comprehensive and completely accurate information. Only four sites (20%) were good sources of information for pregnant women. Internet has proved itself as an important source of information. However, despite numerous websites, only a few offer reliable information to the

Disseminated toxoplasmosis in Antillean manatees Trichechus manatus manatus from Puerto Rico

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Bossart, Gregory D.; Mignucci-Ginannoni, Antonio A.; Rivera-Guzman, Antonio L.; Jimenez-Marrero, Nilda M.; Camus, Alvin C.; Bonde, Robert K.; Dubey, Jitender P.; Reif, John S.

2012-01-01

Necropsies were conducted on 4 Antillean manatees Trichechus manatus manatus that were stranded in single events on the coastal beaches of Puerto Rico from August 2010 to August 2011. Three manatees were emaciated and the gastrointestinal tracts were devoid of digesta. Microscopically, all manatees had severe widespread inflammatory lesions of the gastrointestinal tract and heart with intralesional tachyzoites consistent with Toxoplasma gondii identified by histological, ultrastructural and immunohistochemical techniques. The gastrointestinal lesions included severe, multifocal to diffuse, chronic-active enteritis, colitis and/or gastritis often with associated ulceration, necrosis and hemorrhage. Enteric leiomyositis was severe and locally extensive in all cases and associated with the most frequently observed intralesional protozoans. Moderate to severe, multifocal, chronic to chronic-active, necrotizing myocarditis was also present in all cases. Additionally, less consistent inflammatory lesions occurred in the liver, lung and a mesenteric lymph node and were associated with fewer tachyzoites. Sera (n = 30) collected from free-ranging and captive Puerto Rican manatees and a rehabilitated/released Puerto Rican manatee from 2003 to 2012 were tested for antibodies for T. gondii. A positive T. gondii antibody titer was found in 2004 in 1 (3%) of the free-ranging cases tested. Disease caused by T. gondii is rare in manatees. This is the first report of toxoplasmosis in Antillean manatees from Puerto Rico. Additionally, these are the first reported cases of disseminated toxoplasmosis in any sirenian. The documentation of 4 cases of toxoplasmosis within one year and the extremely low seroprevalence to T. gondiisuggest that toxoplasmosis may be an emerging disease in Antillean manatees from Puerto Rico.

Toxoplasmosis Prevalence in Sheep in Daerah Istimewa Yogyakarta

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W Nurcahyo

2011-05-01

Full Text Available Abstract. A research on toxoplasmosis prevalence in sheep was conducted in Daerah Istimewa Yogyakarta. The objective of the research was to understand the prevalence level of toxoplasmosis in sheep using skin test method by taking the membrane protein of tachyzoit produced in vivo. The research was initiated by producing the tachyzoit membrane protein at the testing animals, later the obtained protein was prepared and used in the skin test method. At the end of the research agglutination test was conducted to confirm the diagnosis using card agglutination test. An optimal dosage of tachyzoit membrane protein used in sheep as the basic material of the skin test was 1.5 mg/ml/head. Result showed the reaction of skin was thickening and the duration after being injected intradermally varied from 12 to 30 minutes in various sizes from 8 to 19 millimetres. The skin test method showed that the prevalence level of toxoplasmosis in Yogyakarta was more than 70%. Key Words: toxoplasmosis, prevalence, skin test

Severe pulmonary compromise in an immunocompetent patient with acute disseminated toxoplasmosis: A Case Report

International Nuclear Information System (INIS)

Salinas, Jorge; Pino, Luis; Lopez Consuelo

2008-01-01

Introduction: The acute toxoplasmosis in the immunocompetent patient, unlike of the positive HIV patient, it is characterizes for prolonged fever, lymph node and nonspecific infectious symptoms, generally with benign course and without systemic commitment. This pathology acquired a very importance in the pregnancy people, where the primary infection can to derivates in the congenital transmission of the illness with irreversible sequels in newborn. Nevertheless, the travel of the people to inhospitable woodsy areas, and the contact with wild-type strain of toxoplasma gondii, to be permitted a new expression of the illness in the immunocompetent patient, with pulmonary, cardiovascular and central nervous system manifestations. They are a high risk for the patient life's. In this study, one case of severe pulmonary commitment for toxoplasma gondii in immunocompetent patient is review; he is admitted to Internal Medicine Service of the Militar Central Hospital's in Bogota. He has a favorable evolution and adequate survival. Objective: To describe the clinical characteristics and follow-up of one patient with severe pulmonary commitment caused by toxoplasma gondii. Design: Case report. Materials and methods: The clinical records of the one patient who was hospitalized in the Militar Central Hospital's in Bogota was reviewed and described. Afterwards, the existing literature on Acute toxoplasmosis in immunocompetent patient was reviewed in PubMed, MD consult and OVID databases. Conclusions: The toxoplasma gondii infection's in immunocompetent patient generally has a benign course without systemic manifestations; nevertheless, the exposure to wild-type strain can to be related with severe pulmonary commitment.

Association between latent toxoplasmosis and cognition in adults: a cross-sectional study.

Science.gov (United States)

Gale, S D; Brown, B L; Erickson, L D; Berrett, A; Hedges, D W

2015-04-01

Latent infection from Toxoplasma gondii (T. gondii) is widespread worldwide and has been associated with cognitive deficits in some but not all animal models and in humans. We tested the hypothesis that latent toxoplasmosis is associated with decreased cognitive function in a large cross-sectional dataset, the National Health and Nutrition Examination Survey (NHANES). There were 4178 participants aged 20-59 years, of whom 19.1% had IgG antibodies against T. gondii. Two ordinary least squares (OLS) regression models adjusted for the NHANES complex sampling design and weighted to represent the US population were estimated for simple reaction time, processing speed and short-term memory or attention. The first model included only main effects of latent toxoplasmosis and demographic control variables, and the second added interaction terms between latent toxoplasmosis and the poverty-to-income ratio (PIR), educational attainment and race-ethnicity. We also used multivariate models to assess all three cognitive outcomes in the same model. Although the models evaluating main effects only demonstrated no association between latent toxoplasmosis and the cognitive outcomes, significant interactions between latent toxoplasmosis and the PIR, between latent toxoplasmosis and educational attainment, and between latent toxoplasmosis and race-ethnicity indicated that latent toxoplasmosis may adversely affect cognitive function in certain groups.

Ocular toxoplasmosis II: clinical features, pathology and management

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Butler, Nicholas J; Furtado, João M; Winthrop, Kevin L; Smith, Justine R

2014-01-01

The term, ocular toxoplasmosis, refers to eye disease related to infection with the parasite, Toxoplasma gondii. Recurrent posterior uveitis is the typical form of this disease, characterized by unilateral, necrotizing retinitis with secondary choroiditis, occurring adjacent to a pigmented retinochoroidal scar and associated with retinal vasculitis and vitritis. Multiple atypical presentations are also described, and severe inflammation is observed in immunocompromised patients. Histopathological correlations demonstrate focal coagulative retinal necrosis, and early in the course of the disease, this inflammation is based in the inner retina. For typical ocular toxoplasmosis, a diagnosis is easily made on clinical examination. In atypical cases, ocular fluid testing to detect parasite DNA by polymerase chain reaction or to determine intraocular production of specific antibody may be extremely helpful for establishing aetiology. Given the high seroprevalence of toxoplasmosis in most communities, serological testing for T. gondii antibodies is generally not useful. Despite a lack of published evidence for effectiveness of current therapies, most ophthalmologists elect to treat patients with ocular toxoplasmosis that reduces or threatens to impact vision. Classic therapy consists of oral pyrimethamine and sulfadiazine, plus systemic corticosteroid. Substantial toxicity of this drug combination has spurred interest in alternative antimicrobials, as well as local forms of drug delivery. At this time, however, no therapeutic approach is curative of ocular toxoplasmosis. PMID:22712598

Laboratory Diagnosis of Congenital Toxoplasmosis

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Pomares, Christelle

2016-01-01

Recent studies have demonstrated that screening and treatment for toxoplasmosis during gestation result in a decrease of vertical transmission and clinical sequelae. Early treatment was associated with improved outcomes. Thus, laboratory methods should aim for early identification of infants with congenital toxoplasmosis (CT). Diagnostic approaches should include, at least, detection of Toxoplasma IgG, IgM, and IgA and a comprehensive review of maternal history, including the gestational age at which the mother was infected and treatment. Here, we review laboratory methods for the diagnosis of CT, with emphasis on serological tools. A diagnostic algorithm that takes into account maternal history is presented. PMID:27147724

First Colombian multicentric newborn screening for congenital toxoplasmosis.

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Jorge Enrique Gómez-Marin

Full Text Available AIMS: To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern. MATERIALS AND METHODS: We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life. RESULTS: 61 positive samples for specific IgM (0.39% and 9 positives for IgA (0.5% were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality. A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city. CONCLUSIONS: Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.

Macular scar secondary to congenital toxoplasmosis | El Hamichi ...

African Journals Online (AJOL)

A 8 years old girl suffers from strabismus since her first months of life. Her visual acuity was very low and could only see fingers moving in her left eye. Her left eye fundus showed a chorioretinal scar in the macula due to congenital toxoplasmosis. The biological findings proved the diagnosis of congenital toxoplasmosis.

Toxoplasmosis and Pregnant Women

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... and General Public. Contact Us Parasites Home Pregnant Women Recommend on Facebook Tweet Share Compartir On this ... my unborn child against toxoplasmosis? Cat owners and women who are exposed to cats should follow the ...

Disseminated toxoplasmosis in an immunocompetent patient from Peruvian Amazon Toxoplasmosis diseminada en un paciente inmunocompetente procedente de la Amazonía peruana

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Juan Nunura

2010-04-01

Full Text Available We report a case of severe toxoplasmosis in an immunocompetent patient, characterized by pneumonia, retinochoroiditis, hepatitis and myositis. Diagnosis was confirmed by serology, T. gondii in thick blood smear and presence of bradyzoites in muscle biopsy. Treatment with pyrimethamine plus sulfadoxine was successful but visual acuity and hip extension were partially recovered. This is the first case report of severe toxoplasmosis in an immunocompetent patient from Peru.Reportamos un caso de toxoplasmosis severa en un paciente inmunocompetente caracterizado por neumonía, retinocoroiditis, hepatitis y miositis. El diagnóstico fue confirmado por serología, el hallazgo de T. gondii en gota gruesa y la presencia de bradizoitos en biopsia muscular. El tratamiento con pirimetamina mas sulfadoxina fue exitoso pero solo hubo una parcial recuperación de la agudeza visual y de la capacidad de extensión de la cadera. Este es el primer reporte de un caso de toxoplasmosis severa en el Perú.

Toxoplasmosis Preventive Behavior and Related Knowledge among Saudi Pregnant Women: An Exploratory Study

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Amin, Tarek Tawfik; Ali, Mohamed Nabil Al; Alrashid, Ahmed Abdulmohsen; Ahmed Al-Agnam, Amena; Al Sultan, Amina Abdullah

2013-01-01

Introduction: Many cases of congenital toxoplasmosis can be prevented provided that pregnant women following hygienic measures to avert risk of infection and to reduce severity of the condition if primary prevention failed. Objectives: This descriptive exploratory study aimed to assess the risk behavior and knowledge related to toxoplasmoisis among Saudi pregnant women attending primary health care centers (PHCs) in Al Hassa, Saudi Arabia and to determine socio-demographic characteristics related to risk behavior and knowledge. Methods: All Saudi pregnant women attending antenatal care at randomly selected six urban and four rural PHCs were approached. Those agreed to participate were interviewed using a pre-tested structured questionnaire collecting data regarding socio-demographic, obstetric history, toxoplasmosis risk behaviors and related knowledge. Results: Of the included pregnant women, 234 (26.8%) have fulfilled the criteria for toxoplasmosis preventive behavior recommended by Centers for Disease Prevention and Control to prevent congenital toxoplasmosis, while 48.9% reported at least one risk behavior and 24.3% reported ≥ two risk behaviors. Logistic regression model revealed that pregnant women aged 20 to toxoplasmosis preventive behavior. Toxoplasmosis-related knowledge showed that many women had identified the role of cats in disease transmission while failed to identify other risk factors including consumption of undercooked meats, unwashed fruits and vegetables, and contacting with soil. Predictors for pregnant women to be knowledgeable towards toxoplasmosis included those aged 30 to toxoplasmosis (OR=2.08) as reveled by multivariate regression model. Conclusion: Pregnant women in Al Hasas, Saudi Arabia, are substantially vulnerable to toxoplasmosis infection as they are lacking the necessary preventive behavior. A sizable portion have no sufficient knowledge for primary prevention of congenital toxoplasmosis, health education at primary care is

Does the prevalence of latent toxoplasmosis and frequency of Rhesus-negative subjects correlate with the nationwide rate of traffic accidents?

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Flegr, Jaroslav; Dama, Madhukar

2014-12-01

Latent toxoplasmosis is probably the most common protistan parasitic disease with many indirect negative impacts on human health. One of the important impacts is impaired psychomotor function leading to reduced driving efficiency in Toxoplasma-seropositive subjects. Numerous case-control studies have established a positive relation between the seroprevalence of Toxoplasma gondii (Nicolle et Manceaux, 1908) and probability of traffic accidents in study populations. The prevalence of toxoplasmosis varies between populations according to local geographical conditions, hygienic practices and kitchen habits. Similarly, we see a striking variation in the incidence of traffic accidents across countries. Hence, we compiled the largest ever data set on the seroprevalence of toxoplasmosis and tried to understand its role in traffic accident-related deaths and disabilities across 87 countries. Simple non-parametric analysis showed a positive and strong relation of T. gondii seroprevalence and traffic accident related disabilities. Further, we conducted multivariate analysis to control for confounding factors. After controlling for wealth, geographical latitude, health of population, length of roads and number of vehicles, the correlation disappeared. When the frequency of RhD negativity and its interaction with toxoplasmosis were included into the model, the effects of toxoplasmosis seemingly returned. However, the analysed data suffered from the problem of multicollinearity. When a proper method of analysis, ridge regression, was applied, the effects of toxoplasmosis prevalence and RhD negativity frequency disappeared again. The existence of a strong correlation between the prevalence of toxoplasmosis and health of population in particular countries, which was the probable cause of multicollinearity and possible reason for the negative result of the present study, suggests that 'asymptomatic' latent toxoplasmosis could have a large impact on public health.

Screening of Toxoplasma gondii infection among childbearing age females and assessment of nurses' role in prevention and control of toxoplasmosis.

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Saleh, Ahmed Megahed Ahmed; Ali, Hisham abd El-Raouf; Ahmed, Salwa Abdalla Mohamed; Hosny, Samah Mostafa; Morsy, Tosson A

2014-08-01

Toxoplasmosis, caused by Toxoplasma gondii is an obligate intracellular zoonotic protozoan parasite, with a worldwide distribution particularly in Arab countries including Egypt. The study evaluated toxoplasmosis infection among childbearing age Egyptian females and assessed the military nursing staff knowledge, attitude and compliance to toxoplasmosis prevention and control measures. The study was conductedin a general military hospital. CROSS-section descriptive research design was used to conduct this study. The subjects consisted of 14 young females (11 were in-patients undergoing gynecological treatment in a military hospital and 3 were staff nurses. On the other hand, 44 staff nurses were available for assessment who met the inclusion criteria. 4 tools were used for data collection: first consisted of self-administered questionnaires to assess nurses' socio-demographic data and knowledge, second rating scale to assess nurses' attitude towards toxoplasmosis infection and its prevention, third performance check list to measure nurses' compliance to infection control measures, and fourth measured the anti-Toxoplasma antibodies by commercial indirect hemagglutination test (IHAT). The results showed that almost half of the nurses had satisfactory levels of knowledge, attitude, and compliance to toxoplasmosis infection control measures. 22.2% of the pregnant women and 20% of non-pregnant ones showed antibodies against T. gondii. Thus health education about toxoplasmosis should be tailored to women whether married or single to help in avoiding the risk of infection. Frequent periodic IHAT should be done for people who continuously contact with cats. Adherence to strict infection prevention measures is a must to eliminate exposure to toxoplasmosis infection. Training intervention should be implemented to achieve successful improvement in knowledge, attitude, and compliance of toxoplasmosis control measures.

Serological diagnosis of Toxoplasma gondii infection: Recommendations from the French National Reference Center for Toxoplasmosis.

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Villard, O; Cimon, B; L'Ollivier, C; Fricker-Hidalgo, H; Godineau, N; Houze, S; Paris, L; Pelloux, H; Villena, I; Candolfi, E

2016-01-01

Toxoplasmosis manifests no clinical signs in 80% of cases in immunocompetent patient, causing immunization characterized by the persistence of cysts, particularly in brain, muscles, and retina. Assessing the serological status, based on testing for serum toxoplasma IgG and IgM antibodies, is essential in cases that are increasingly at risk for the more severe disease forms, such as congenital or ocular toxoplasmosis. This disease also exposes immunosuppressed patients to reactivation, which can lead to more widespread forms and increased mortality. By interpreting the serological results, we can estimate the risk of contamination or reactivation and define appropriate prophylactic and preventive measures, such as hygienic and dietetic, therapeutic, biological, and clinical follow-up, according to the clinical context. We hereby propose practical approaches based on serological data, resulting from a consensus of a group of experts from the French National Reference Center Network for Toxoplasmosis, according to both routine and specific clinical situations. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Fatal toxoplasmosis in an immunosuppressed domestic cat from Brazil caused by Toxoplasma gondii clonal type I

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Hilda Fátima de Jesus Pena

Full Text Available Abstract The objective of the study was to report on a fatal case of feline toxoplasmosis with coinfection with the feline leukemia virus (FeLV. A domestic cat (Felis silvestris catus presented intense dyspnea and died three days later. In the necropsy, the lungs were firm, without collapse and with many white areas; moderate lymphadenomegaly and splenomegaly were also observed. The histopathological examination showed severe necrotic interstitial bronchopneumonia and mild necrotic hepatitis, associated with intralesional cysts and tachyzoites of Toxoplasma gondii that were positive by anti-T. gondii immunohistochemical (IHC evaluation. The bone marrow showed chronic myeloid leukemia and the neoplastic cells were positive by anti-FeLV IHC evaluation. DNA extracted from lungs was positive for T. gondii by PCR targeting REP-529. T. gondii was characterized by PCR-RFLP and by the microsatellites technique. ToxoDB-PCR-RFLP #10, i.e. the archetypal type I, was identified. Microsatellite analysis showed that the strain was a variant of type I with two atypical alleles. This was the first time that a T. gondii clonal type I genotype was correlated with a case of acute toxoplasmosis in a host in Brazil.

Seroprevalence study of toxoplasmosis in pregnant women referred to Aleshtar rural and urban health centers in 2008

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korosh Cheraghi pour

2010-02-01

Full Text Available Background: Toxoplasmosis is one of the a parasitic infectious caused by the protozoan Toxoplasma gondii. Congenital toxoplasmosis can cause abortion or fetus damage in pregnant women. The purpose of this study was to determine the seroprevalence of toxoplasmosis (IgG & IgM among the pregnant women referred to Aleshtar rural and urban health centers in 2008. Materials and Methods: Total 331 blood samples were collected from 204 urban and 127 rural pregnant wemon referred to rural and urban health centers of Aleshtar. After recording their information in the questionnaire and preparation of sample, all samples were evaluated with IgG- and IgM-ELISA to detect anti-Toxoplasma gondii antibodies. Data were analysed by descriptive statistics and chi-square test. Results: In this study seroprevalence of toxoplasmosis in urban and rural pregnant women were 36/2% and 44%, respectively. And 11. 2% of the urban and 9. 4% of the rural women suffered from acute Toxoplasma infection while 25% and 34. 6% of the urban and the rural cases had chronic infection, respectively. The results of analysis showed that there were significant relationships between seropositivity (IgG and IgM and education level, age, contact with raw meat, contact with cat, kind of food, washing vegetables, consumption of vegetables and milk in both urban and rural pregnant women (p<0. 05. There was no significant difference between seropositivity and other variables. Conclusion: The results of this study showed that the high level of education and preferment health awareness can reduce the risk of toxoplasmosis. Nevertheless, %60. 8 of the pregnant women in this study didn’t have previous history of toxoplasma infection and are exposed to primary infectin and acute disease. Therefore, preventive measures and controlled programs are necessary.

Cerebral computed tomography in men with acquired immunodeficiency syndrome

International Nuclear Information System (INIS)

Brun, B.; Boesen, F.; Gerstoft, J.; Nielsen, J.O.; Praestholm, J.; Rigshospitalet, Copenhagen; Hvidovre Hospital; Hvidovre Hospital; Hvidovre Hospital

1986-01-01

Cerebral CT scannings were performed in 19 homosexual men with the acquired immunodeficiency syndrome (AIDS). Nearly half of them (9 patients) had cortical atrophy. Three patients with toxoplasmosis had cerebral pathology, in two of them with ring enhancement while the third had an ill-defined nonspecific lesion with slight heterogeneous enhancement without ring formation. Two patients with multifocal leucoencephalopathy and non-Hodgkin's lymphoma, respectively, presented non-enhancing, low attenuating lesions at CT. (orig.)

Cerebral toxoplasmosis: case review and description of a new imaging sign

International Nuclear Information System (INIS)

Masamed, R.; Meleis, A.; Lee, E.W.; Hathout, G.M.

2009-01-01

Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

Cerebral toxoplasmosis: case review and description of a new imaging sign

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Masamed, R. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States)], E-mail: rmasamed@mednet.ucla.edu; Meleis, A. [Princeton University, New Jersey, CA (United States); Lee, E.W. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Hathout, G.M. [Department of Radiological Sciences, UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, Olive View UCLA Medical Center, Los Angeles, CA (United States); Department of Neuroradiology, West L.A. VA Medical Center, Los Angeles, CA (United States)

2009-05-15

Toxoplasmosis can have catastrophic consequences in immunocompromised patients if left untreated. Accurate diagnosis is difficult, as there is substantial overlap between the imaging findings and presenting clinical syndromes of cerebral toxoplasmosis and primary central nervous system lymphoma. This paper reviews the previously described and fairly well-known post-contrast computed tomography (CT) and T1-weighted (W) magnetic resonance imaging (MRI) target signs seen in toxoplasmosis. In addition, it offers a new imaging sign, the T2W/FLAIR (fluid attenuated inversion recovery) target sign, which is often seen in clinical practice but not well-published, as an aid to the diagnosis of cerebral toxoplasmosis.

Effects of latent toxoplasmosis on autoimmune thyroid diseases in pregnancy.

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Kaňková, Šárka; Procházková, Lucie; Flegr, Jaroslav; Calda, Pavel; Springer, Drahomíra; Potluková, Eliška

2014-01-01

Toxoplasmosis, one of the most common zoonotic diseases worldwide, can induce various hormonal and behavioural alterations in infected hosts, and its most common form, latent toxoplasmosis, influences the course of pregnancy. Autoimmune thyroid diseases (AITD) belong to the well-defined risk factors for adverse pregnancy outcomes. The aim of this study was to investigate whether there is a link between latent toxoplasmosis and maternal AITD in pregnancy. Cross-sectional study in 1248 consecutive pregnant women in the 9-12th gestational weeks. Serum thyroid-stimulating hormone (TSH), thyroperoxidase antibodies (TPOAb), and free thyroxine (FT4) were assessed by chemiluminescence; the Toxoplasma status was detected by the complement fixation test (CFT) and anti-Toxoplasma IgG enzyme-linked immunosorbent assay (ELISA). Overall, 22.5% of the women were positive for latent toxoplasmosis and 14.7% were screened positive for AITD. Women with latent toxoplasmosis had more often highly elevated TPOAb than the Toxoplasma-negative ones (p = 0.004), and latent toxoplasmosis was associated with decrease in serum TSH levels (p = 0.049). Moreover, we found a positive correlation between FT4 and the index of positivity for anti-Toxoplasma IgG antibodies (p = 0.033), which was even stronger in the TPOAb-positive Toxoplasma-positive women, (p = 0.014), as well as a positive correlation between FT4 and log2 CFT (p = 0.009). Latent toxoplasmosis was associated with a mild increase in thyroid hormone production in pregnancy. The observed Toxoplasma-associated changes in the parameters of AITD are mild and do not seem to be clinically relevant; however, they could provide new clues to the complex pathogenesis of autoimmune thyroid diseases.

Congenital toxoplasmosis transmitted by human immunodeficiency-virus infected women

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Kátia Martins Lopes de Azevedo

Full Text Available We report the occurrence of congenital toxoplasmosis in three infants born to HIV infected women who had high anti-toxoplasma IgG and negative IgM during pregnancy. We briefly reviewed available literature and discussed the possible transmission mechanisms of congenital toxoplasmosis among HIV infected pregnant women. Serum samples were tested for Toxoplasma gondii IgM and IgG antibodies using commercial enzyme immunoassay and IgG-avidity tests. In the first case, fetal death occurred at 28th week of gestation. In the second case, congenital toxoplasmosis was diagnosis at 6th month of life; and in the third case, an HIV-infected newborn, congenital toxoplasmosis was asymptomatic. These cases point out to the possibility of enhanced maternal-fetal transmission of T. gondii infection by HIV-infected women chronically infected, which may have important public health consequences, considering that increasing frequency of HIV-infection has been observed among women of childbearing age around the world.

Tomographic findings of acute pulmonary toxoplasmosis in immunocompetent patients.

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de Souza Giassi, Karina; Costa, Andre Nathan; Apanavicius, Andre; Teixeira, Fernando Bin; Fernandes, Caio Julio Cesar; Helito, Alfredo Salim; Kairalla, Ronaldo Adib

2014-11-25

Toxoplasmosis is one of the most common human zoonosis, and is generally benign in most of the individuals. Pulmonary involvement is common in immunocompromised subjects, but very rare in immunocompetents and there are scarce reports of tomographic findings in the literature. The aim of the study is to describe three immunocompetent patients diagnosed with acute pulmonary toxoplasmosis and their respective thoracic tomographic findings. Acute toxoplasmosis was diagnosed according to the results of serological tests suggestive of recent primary infection and the absence of an alternative etiology. From 2009 to 2013, three patients were diagnosed with acute respiratory failure secondary to acute toxoplasmosis. The patients were two female and one male, and were 38, 56 and 36 years old. Similarly they presented a two-week febrile illness and progressive dyspnea before admission. Laboratory tests demonstrated lymphocytosis, slight changes in liver enzymes and high inflammatory markers. Tomographic findings were bilateral smooth septal and peribronchovascular thickening (100%), ground-glass opacities (100%), atelectasis (33%), random nodules (33%), lymph node enlargement (33%) and pleural effusion (66%). All the patients improved their symptoms after treatment, and complete resolution of tomographic findings were found in the followup. These cases provide a unique description of the presentation and evolution of pulmonary tomographic manifestations of toxoplasmosis in immunocompetent patients. Toxoplasma pneumonia manifests with fever, dyspnea and a non-productive cough that may result in respiratory failure. In animal models, changes were described as interstitial pneumonitis with focal infiltrates of neutrophils that can finally evolve into a pattern of diffuse alveolar damage with focal necrosis. The tomographic findings are characterized as ground glass opacities, smooth septal and marked peribronchovascular thickening; and may mimic pulmonary congestion

THERAPY FOR OCULAR TOXOPLASMOSIS

NARCIS (Netherlands)

ROTHOVA, A; MEENKEN, C; BRINKMAN, CJ; BAARSMA, GS; BOENTAN, TN; DEJONG, PTVM; KLAASSENBROEKEMA, N; SCHWEITZER, CMC; TIMMERMAN, Z; DEVRIES, J; ZAAL, MJW; KIJLSTRA, A

1993-01-01

We conducted a prospective multicenter study of the efficacy of current therapeutic strategies for ocular toxoplasmosis in 149 patients. Treatment consisted of the following three triple-drug combinations: group 1, pyrimethamine, sulfadiazine, and corticosteroids; group 2, clindamycin, sulfadiazine,

Therapy for ocular toxoplasmosis

NARCIS (Netherlands)

Rothova, A.; Meenken, C.; Buitenhuis, H. J.; Brinkman, C. J.; Baarsma, G. S.; Boen-Tan, T. N.; de Jong, P. T.; Klaassen-Broekema, N.; Schweitzer, C. M.; Timmerman, Z.

1993-01-01

We conducted a prospective multicenter study of the efficacy of current therapeutic strategies for ocular toxoplasmosis in 149 patients. Treatment consisted of the following three triple-drug combinations: group 1, pyrimethamine, sulfadiazine, and corticosteroids; group 2, clindamycin, sulfadiazine,

'Atypical' bacteria are a common cause of community-acquired ...

African Journals Online (AJOL)

Objectives. To assess the proportion of cases of community· acquired pneumonia caused by 'atypical' bacteria, inclUding the recently discovered Chlamydia pneumoniae, and to compare the clinical, radiographic and laboratory features of patients with and without 'atypical' bacteria. Methods. A prospective serological ...

[Serological survey of animal toxoplasmosis in Senegal].

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Davoust, B; Mediannikov, O; Roqueplo, C; Perret, C; Demoncheaux, J-P; Sambou, M; Guillot, J; Blaga, R

2015-02-01

Toxoplasma gondii is an obligate, intracellular, parasitic protozoan within the phylum Apicomplexa that causes toxoplasmosis in mammalian hosts (including humans) and birds. We used modified direct agglutination test for the screening of the animals' sera collected in Senegal. In total, 419 animals' sera have been studied: 103 bovines, 43 sheep, 52 goats, 63 horses, 13 donkeys and 145 dogs. The collection of sera was performed in four different regions of Senegal: Dakar, Sine Saloum, Kedougou and Basse Casamance from 2011 to 2013. We have revealed antibodies in 13% of bovines, 16% of sheep, 15% of goats, 30% of horses, 23% of donkeys and 67% of dogs. Private dogs from villages were more often to have the anti-Toxoplasma antibodies compared to security society-owned dogs from Dakar. It may be explained by different meal consumed by dogs (factory-produced meal for dogs from Dakar vs. irregular sources for village dogs). Intense circulation of T. gondii in the studied zone may explain the unusually high seroprevalence among horses and donkeys. Tropical climate with high temperature and humidity is favorable for the conservation of oocysts of T. gondii. Results presented here may contribute to the evaluation of the risks of toxoplasmosis in humans in Senegal.

Atovaquone for Prophylaxis of Toxoplasmosis after Allogeneic Hematopoietic Stem Cell Transplantation.

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Mendorf, Alexander; Klyuchnikov, Evgeny; Langebrake, Claudia; Rohde, Holger; Ayuk, Francis; Regier, Marc; Christopeit, Maximilian; Zabelina, Tatjana; Bacher, Adelbert; Stübig, Thomas; Wolschke, Christine; Bacher, Ulrike; Kröger, Nicolaus

2015-01-01

Toxoplasmosis and infections by other opportunistic agents such as Pneumocystis jirovecii constitute life-threatening risks for patients after allogeneic hematopoietic stem cell transplantation. Trimethoprim/sulfamethoxazole (TMP-SMX) has been well established for post-transplant toxoplasmosis and pneumocystis prophylaxis, but treatment may be limited due to toxicity. We explored atovaquone as an alternative and compared it with TMP-SMX regarding toxicity and efficacy during the first 100 days after transplantation in 155 consecutive adult stem cell recipients. Eight patients with a prior history of TMP-SMX intolerance received atovaquone as first-line prophylaxis. TMP-SMX was used for 141 patients as first-line strategy, but 13 patients (9.2%) were later switched to atovaquone due to TMP-SMX toxicity or gastrointestinal symptoms. No active toxoplasmosis or active P. jirovecii infection developed under continued prophylaxis with either TMP-SMX or atovaquone. However, for reasons of TMP-SMX and/or atovaquone toxicity, 7 patients were unable to tolerate any efficacious toxoplasmosis prophylaxis and therefore obtained inhalative pentamidine as P. jirovecii prophylaxis but no toxoplasmosis prophylaxis. Importantly, 2 of these patients developed severe toxoplasmosis. In summary, atovaquone appears as a valid alternative for at least some post-transplant patients who cannot tolerate TMP-SMX. This should be further confirmed by multicenter trials. © 2015 S. Karger AG, Basel.

Clinical characteristics and computed tomography findings of pulmonary toxoplasmosis after hematopoietic stem cell transplantation.

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Sumi, Masahiko; Norose, Kazumi; Hikosaka, Kenji; Kaiume, Hiroko; Takeda, Wataru; Kirihara, Takehiko; Kurihara, Taro; Sato, Keijiro; Ueki, Toshimitsu; Hiroshima, Yuki; Kuraishi, Hiroshi; Watanabe, Masahide; Kobayashi, Hikaru

2016-12-01

The prognosis of pulmonary toxoplasmosis, including disseminated toxoplasmosis involving the lungs, following hematopoietic stem cell transplantation (HSCT) is extremely poor due to the difficulties associated with early diagnosis and the rapidly progressive deterioration of multiorgan function. In our institution, we identified nine cases of toxoplasmosis, representing incidences of 2.2 and 19.6 % among all HSCT recipients and seropositive HSCT recipients, respectively. Of the patients with toxoplasmosis, six had pulmonary toxoplasmosis. Chest computed tomography (CT) findings revealed centrilobular, patchy ground-glass opacities (n = 3), diffuse ground-glass opacities (n = 2), ground-glass opacities with septal thickening (n = 1), and marked pleural effusion (n = 1). All cases died, except for one with suspected pulmonary toxoplasmosis who was diagnosed by a polymerase chain reaction assay 2 days after the onset of symptoms. In pulmonary toxoplasmosis, CT findings are non-specific and may mimic pulmonary congestion, atypical pneumonia, viral pneumonitis, and bronchopneumonia. Early diagnosis and treatment is crucial for overcoming this serious infectious complication. Pulmonary toxoplasmosis should be considered during differential diagnosis in a recipient with otherwise unexplained signs of infection and CT findings with ground-glass opacities, regardless of the distribution.

Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA

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Maria Isabel Lynch

2009-09-01

Full Text Available Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with ocular toxoplasmosis. Tears from 156 patients with active posterior uveitis were analysed; 82 of them presented characteristics of ocular toxoplasmosis (standard lesion and 74 patients presented uveitis due to other aetiologies. Cases of active posterior uveitis were considered standard when a new inflammatory focus satellite to old retinochoroidal scars was observed. The determination of anti-T. gondii sIgA was made using an ELISA test with crude tachyzoite antigenic extracts. Tears were collected without previous stimulation. Detection of sIgA showed 65.9% sensitivity (95% CI = 54.5-74.4, 71.6% specificity (95% CI = 59.8-81.2, a positive predictive value of 72% (95% CI = 60.3-81.5 and a negative predictive value of 65.4% (95% CI = 54.0-75.4. sIgA reactivity was higher in the tears of patients with active posterior uveitis due to T. gondii (p < 0.05. The test is useful for differentiating active posterior uveitis due to toxoplasmosis from uveitis caused by other diseases.

Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA.

Science.gov (United States)

Lynch, Maria Isabel; Malagueño, Elizabeth; Lynch, Luiz Felipe; Ferreira, Silvana; Stheling, Raphael; Oréfice, Fernando

2009-09-01

Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA) antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with ocular toxoplasmosis. Tears from 156 patients with active posterior uveitis were analysed; 82 of them presented characteristics of ocular toxoplasmosis (standard lesion) and 74 patients presented uveitis due to other aetiologies. Cases of active posterior uveitis were considered standard when a new inflammatory focus satellite to old retinochoroidal scars was observed. The determination of anti-T. gondii sIgA was made using an ELISA test with crude tachyzoite antigenic extracts. Tears were collected without previous stimulation. Detection of sIgA showed 65.9% sensitivity (95% CI = 54.5-74.4), 71.6% specificity (95% CI = 59.8-81.2), a positive predictive value of 72% (95% CI = 60.3-81.5) and a negative predictive value of 65.4% (95% CI = 54.0-75.4). sIgA reactivity was higher in the tears of patients with active posterior uveitis due to T. gondii (p < 0.05). The test is useful for differentiating active posterior uveitis due to toxoplasmosis from uveitis caused by other diseases.

Long term ocular and neurological involvement in severe congenital toxoplasmosis

NARCIS (Netherlands)

Meenken, C.; Assies, J.; van Nieuwenhuizen, O.; Holwerda-van der Maat, W. G.; van Schooneveld, M. J.; Delleman, W. J.; Kinds, G.; Rothova, A.

1995-01-01

This study was set up to determine the long term ocular and systemic sequelae in patients with severe congenital toxoplasmosis. Cross sectional and retrospective study of 17 patients with severe congenital toxoplasmosis. In addition to chorioretinitis (100%), the most common abnormal ocular features

[Prevention of congenital toxoplasmosis in a Buenos Aires hospital].

Science.gov (United States)

Carral, Liliana; Kaufer, Federico; Olejnik, Patricia; Freuler, Cristina; Durlach, Ricardo

2013-01-01

The prevention of congenital toxoplasmosis is based on providing information to women, serologic diagnosis and treatment of the infected mother and child. In this article we present the results of 12 years of implementation of a congenital toxoplasmosis prevention program in which we measured the mother's infection incidence rate, the transmission rate and the number and severity of infection in newborns. The study was performed on 12035 pregnant women in the period 2000-2011. The prevalence rate of antibodies against Toxoplasma gondii was 18.33% (2206/12035). Thirty-seven out of 9792 susceptible women presented acute infection and the mother's infection incidence rate was 3.78 per 1000 births. The transplacental transmission rate was 5.4% (2/37). Two newborns presented congenital toxoplasmosis infection, one had no clinical signs while the other presented strabismus and chorioretinitis. Thirty-five infected mothers and the two children with congenital infection were treated. The transmission rates obtained allow consider this prevention program as a valid resource to minimize the impact of congenital toxoplasmosis.

Serologic evaluation of toxoplasmosis in matrimonial women in Babol, Iran.

Science.gov (United States)

Youssefi, M R; Sefidgar, A A; Mostafazadeh, A; Omran, S Mahdavi

2007-05-01

To investigate anti-toxoplasmosis in matrimonial women, samples collected from who referred to Babol health center, that is the only pre-marriage laboratory guide center in Babol. This descriptive-cross sectional study has carried out on 241 matrimonial women to consider anti toxoplasmosis antibodies (IgG, IgM) by ELISA (Enzyme Linked Immunosorbant Assay). In this study, 241 women between 13 to 40 years old were considered. The average age was 20.98 years. Of these cases, 47.3% were urban and 52.7% were rural. 63.9% had IgG and 12.4% had IgM anti-toxoplasmosis antibody. This study carried out to determine anti toxoplasmosis antibodies in Babol in the first half of 2004. Dispersed studies have been done to determine the prevalence oftoxoplasmosis in Iran and mostly have reported a high and different prevalence oftoxoplasmosis in different parts of country.

Prenatal diagnosis and prevention of toxoplasmosis in pregnant women in Northern Vietnam: study protocol.

Science.gov (United States)

Smit, G Suzanne A; Vu, Thi Lam Binh; Do, Trung Dung; Speybroeck, Niko; Devleesschauwer, Brecht; Padalko, Elizaveta; Roets, Ellen; Dorny, Pierre

2017-05-25

In Vietnam, no systematic prenatal toxoplasmosis screening is in place, and only few studies have assessed the prevalence and importance of this zoonotic parasite infection. In addition, no studies have been conducted to assess the risk factors associated with toxoplasmosis. This study protocol was developed to determine the seroprevalence of toxoplasmosis in pregnant women in Hanoi and Thai Binh, Northern Vietnam, and to evaluate the association with risk factors and congenital toxoplasmosis. The protocol was developed in a way that it could potentially evolve into a countrywide prenatal diagnosis and prevention program, with the main focus on primary prevention. The collaborating gynaecologists will invite eligible pregnant women attending antenatal care for the first time to participate in the study. At first consult, information about toxoplasmosis and its prevention will be provided. All participants will be asked to fill in a questionnaire, which is designed to analyse socio-demographic and biologically plausible risk factors associated with toxoplasmosis, and blood samples will be collected to determine the seroprevalence of toxoplasmosis in pregnant women. In case there is suspicion of a primary infection during pregnancy, the concerned women will be followed-up by the gynaecologists according to a predefined protocol. Every participant will be informed on her serological status, risk factors and prevention measures and is offered appropriate medical information and medical follow-up if required. The hypothesis is that congenital toxoplasmosis is an important but currently under-diagnosed public health problem in Vietnam. This study can strengthen sustainable control of toxoplasmosis in Vietnam, provide a protocol for prenatal diagnosis, boost overall awareness, improve the knowledge about toxoplasmosis prevention and can be essential for evidence-based health policy.

Therapy of ocular toxoplasmosis

NARCIS (Netherlands)

Rothova, A.; Buitenhuis, H. J.; Meenken, C.; Baarsma, G. S.; Boen-Tan, T. N.; de Jong, P. T.; Schweitzer, C. M.; Timmerman, Z.; de Vries, J.; Zaal, M. J.

1989-01-01

We performed a prospective multicentre study to evaluate the efficacy of therapeutic strategies currently used for ocular toxoplasmosis in a large number of patients (n = 106). Treatment was given for at least four weeks and consisted of three triple drug combinations: group 1, pyrimethamine,

Effect of toxoplasmosis and brucellosis on some biochemical parameters in ewes

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N. A. J. Al- Hussary

2010-01-01

Full Text Available The present study was conducted to evaluate the effects of infection of ewes with toxoplasmosis and/or brucellosis on someserum biochemical parameters. Ninety six samples of blood were collected from aborted ewes at different stages of gestation,suspected to be infected with toxoplasmosis and /or brucellosis from different regions in Nineveh governorate. The percentageof toxoplasma and brucella infection depending on Latex Agglutination Test (LAT and Rose Bengal Test were 21.88% and23.96% respectively. The results of biochemical analysis showed that infection with toxoplasma caused significant elevation ofserum activities of aspartate aminotransferase (AST, alanine aminotransferase (ALT and lactate dehydrogenase (LDH. Aswell as the concentrations of glucose, total protein and copper. Where as the activity of alkaline phosphatase (ALP and theconcentration of calcium and zinc were reduced. Infection with brucellosis caused a significant increased in serum AST, ALTand LDH, ALP and creatin phosphokinase (CPK activities, and glucose, zinc and cholesterol concentrations. While serumcalcium and total protein concentration were decreased. Association of toxoplasma and brucella infection induced significantelevation of serum AST, ALT and LDH and CPK activities and the concentrations of glucose and copper with significant reduction in serum ALP activity and both calcium and zinc concentrations. It was concluded from this study that infection ofewes with toxoplasma and/or brucella caused changes in some biochemical parameters in the serum.

STATUS KEKEBALAN DAN FAKTOR RISIKO TOXOPLASMOSIS PADA WANITA USIA SUBUR HASIL RISKESDAS 2007

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Rabea Pangerti Jekti

2015-04-01

Full Text Available Toxoplasmosis disebabkan oleh parasit Toxoplasma gondii. Diperkirakan sekitar 30 - 50% populasi dunia telah terinfeksi oleh toxoplasma, sebagian besar tanpa gejala. Penderita dengan kekebalan tubuh yang kuat apabila terinfeksi T. gondii pada umumnya tidak mengalami keadaan patologik yang nyata walaupun pada beberapa kasus dapat juga mengalami pembesaran kelenjar limfe, rasa lelah yang berlebihan, miokarditis akut, miositis hingga radang otak. Analisis ini bertujuan untuk mengukur hubungan kekebalan tubuh (titer antibodi pada wanita usia subur  terhadap kejadian toxoplasmosis  dan faktor risiko tingkat kekebalan tubuh. . Analisis ini menggunakan data potong lintang Riskesdas 2007. Subjek adalah wanita usia subur (WUS yang berusia 15-45 tahun. Kekebalan terhadap toxoplasmosis dilihat dengan mengukur kadar immunoglobulin G (IgG melalui tehnik ELISA (toxolisa. Subjek dikatakan tidak memiliki kekebalan terhadap toxoplasmosis jika toxolisanya <32 IU Sampel yang terpilih di analisis lebih lanjut untuk mengetahui faktor demografi, risiko, dan perilaku yang berhubungan dengan status kekebalan toksoplasmosis. Jumlah sampel yang terpilih dan mempunyai data yang lengkap sejumlah 6068 subjek dari 10521 women in repeoductive age. Hasil menunjukkan bahwa 63,7% memiliki kekebalan, dan 36,3% tidak memiliki kekebalan terhadap toxoplasmosis.  WUS yang berusia 15-17 tahun mempunyai risiko yang lebih tinggi untuk tidak memiliki kekebalan toxoplasmosis yaitu sebesar 26% (ORs=1,26, 95% CI 1,03-1,55, p=0,027, begitu juga dengan WUS yang berstatus Ibu Rumah Tangga (IRT dan pelajaryaitu 16% (ORs=1,16, 95% CI 1,04-1,30, p=0,007, dan WUS yang berstatus kawin yaitu 30% (ORs=1,30, 95% CI 1,13-1,49, p=0,000. WUS yang berusia 15-17 tahun, berstatus kawin, dan IRT serta pelajar, merupakan kelompok yang berisiko tidak memiliki kekebalan terhadap toxoplasmosis, sehingga perlu kewaspadaan untuk meningkatkan upaya pencegahan dan perlindungan terhadap toxoplasmosis.   Kata kunci

Cotrimoxazole in the Treatment of a Midbrain Toxoplasmosis in HIV ...

African Journals Online (AJOL)

This is a case of cerebral toxoplasmosis presenting at the time of diagnosis of HIV. Cerebral toxoplasmosis is one of the most common intracranial opportunistic diseases occuring in HIV, presenting with mass lesions. A 52 year-old woman who presented to Olabisi Onabanjo University Teaching Hospital (OOUTH) with ...

Ga-67 citrate myocardial uptake in a patient with AIDS, toxoplasmosis, and myocarditis

International Nuclear Information System (INIS)

Memel, D.S.; DeRogatis, A.J.; William, D.C.

1991-01-01

A 38-year-old man with AIDS presented with fever of unknown origin, splenomegaly, anemia, and thrombocytopenia. Admission laboratory data revealed a positive toxoplasmosis titer in the blood. The initial chest x-ray showed small bilateral pleural effusions, a normal cardiac silhouette, no infiltrates, and no interstitial edema. Ga-67 imaging revealed markedly abnormal uptake in the myocardium. A diagnosis of toxoplasmosis myocarditis was made based on laboratory and imaging data. The patient was treated for toxoplasmosis. No myocardial uptake of tracer was demonstrated on a follow-up Ga-67 scan, performed after completion of treatment for toxoplasmosis

[Evaluation of the toxoplasmosis seroprevalence in pregnant women and creating a diagnostic algorithm].

Science.gov (United States)

Mumcuoglu, Ipek; Toyran, Alparslan; Cetin, Feyza; Coskun, Feride Alaca; Baran, Irmak; Aksu, Neriman; Aksoy, Altan

2014-04-01

Toxoplasma gondii, an obligatory intracellular protozoon is widely distributed around the world and can infect all mammals and birds. While acquired toxoplasmosis is usually asymptomatic in healthy subjects, acute infection during pregnancy may lead to abortion, stillbirth, fetal neurological and ocular damages. For the prevention of congenital toxoplasmosis it is recommended that a screening programme and a diagnostic algorithm in pregnant women should be implemented while considering the cost effectiveness. Thus, it is necessary to determine the seroprevalence of toxoplasmosis in pregnant women and the actual risk of T.gondii transmission during pregnancy in a certain area. The aims of this study were to detect the T.gondii seropositivity in the pregnant women admitted to our hospital and to create a diagnostic algorithm in order to solve the problems arising from interpretation of the serological test results. A total of 6140 women aged 15-49 years who were admitted to our hospital between April 1st, 2010 to July 31st, 2013, were evaluated retrospectively. In the serum samples, T.gondii IgM, IgG and IgG avidity tests were performed by VIDAS automated analyzer using TOXO IgM, TOXO IgG II and TOXO IgG avidity kits (bioMerieux, France). It was noted that, both T.gondii IgM and IgG tests were requested from 4758 (77.5%) of the pregnant women, while only IgM test from 1382 (22.5%) cases. Sole IgM positivity was found as 0.2% (11/6140), IgG as 26.4% (1278/4758) and both IgM + IgG as 0.9% (44/4758). T.gondii IgG avidity tests were requested from 12 of 44 women who were found both IgM and IgG positive and eight of them revealed high avidity and four low avidity. Avidity test was ordered for the 91 (7.1%) of 1278 sole IgG positive cases and four of them were found to have low avidity. IgG avidity test was ordered for 554 (16.2%) of IgM and/or IgG negative subjects, however, the test was not performed according to rejection criteria of the laboratory. It was noticed that

Toxoplasmosis Titers and past Suicide Attempts Among Older Adolescents Initiating SSRI Treatment.

Science.gov (United States)

Coryell, William; Yolken, Robert; Butcher, Brandon; Burns, Trudy; Dindo, Lilian; Schlechte, Janet; Calarge, Chadi

2016-01-01

Latent infection with toxoplasmosis is a prevalent condition that has been linked in animal studies to high-risk behaviors, and in humans, to suicide and suicide attempts. This analysis investigated a relationship between suicide attempt history and toxoplasmosis titers in a group of older adolescents who had recently begun treatment with an SSRI. Of 108 participants, 17 (15.7 %) had a lifetime history of at least one suicide attempt. All were given structured and unstructured diagnostic interviews and provided blood samples. Two individuals (11.9%) with a past suicide attempt, and two (2.1%) without this history, had toxoplasmosis titers ≥ 10 IU/ml (p = 0.166). Those with a past suicide attempt had mean toxoplasmosis titers that were significantly different (p = 0.018) from those of patients who lacked this history. An ROC analysis suggested a lower optimal threshold for distinguishing patients with and without suicide attempts (3.6 IU/ml) than that customarily used to identify seropositivity. Toxoplasmosis titers may quantify a proneness to suicidal behavior in younger individuals being treated with antidepressants.

Genetic and Epigenetic Factors at COL2A1 and ABCA4 Influence Clinical Outcome in Congenital Toxoplasmosis

Science.gov (United States)

Jamieson, Sarra E.; de Roubaix, Lee-Anne; Cortina-Borja, Mario; Tan, Hooi Kuan; Mui, Ernest J.; Cordell, Heather J.; Kirisits, Michael J.; Miller, E. Nancy; Peacock, Christopher S.; Hargrave, Aubrey C.; Coyne, Jessica J.; Boyer, Kenneth; Bessieres, Marie-Hélène; Buffolano, Wilma; Ferret, Nicole; Franck, Jacqueline; Kieffer, François; Meier, Paul; Nowakowska, Dorota E.; Paul, Malgorzata; Peyron, François; Stray-Pedersen, Babill; Prusa, Andrea-Romana; Thulliez, Philippe; Wallon, Martine; Petersen, Eskild; McLeod, Rima; Gilbert, Ruth E.; Blackwell, Jenefer M.

2008-01-01

Background Primary Toxoplasma gondii infection during pregnancy can be transmitted to the fetus. At birth, infected infants may have intracranial calcification, hydrocephalus, and retinochoroiditis, and new ocular lesions can occur at any age after birth. Not all children who acquire infection in utero develop these clinical signs of disease. Whilst severity of disease is influenced by trimester in which infection is acquired by the mother, other factors including genetic predisposition may contribute. Methods and Findings In 457 mother-child pairs from Europe, and 149 child/parent trios from North America, we show that ocular and brain disease in congenital toxoplasmosis associate with polymorphisms in ABCA4 encoding ATP-binding cassette transporter, subfamily A, member 4. Polymorphisms at COL2A1 encoding type II collagen associate only with ocular disease. Both loci showed unusual inheritance patterns for the disease allele when comparing outcomes in heterozygous affected children with outcomes in affected children of heterozygous mothers. Modeling suggested either an effect of mother's genotype, or parent-of-origin effects. Experimental studies showed that both ABCA4 and COL2A1 show isoform-specific epigenetic modifications consistent with imprinting. Conclusions These associations between clinical outcomes of congenital toxoplasmosis and polymorphisms at ABCA4 and COL2A1 provide novel insight into the molecular pathways that can be affected by congenital infection with this parasite. PMID:18523590

Genetic and epigenetic factors at COL2A1 and ABCA4 influence clinical outcome in congenital toxoplasmosis.

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Sarra E Jamieson

2008-06-01

Full Text Available Primary Toxoplasma gondii infection during pregnancy can be transmitted to the fetus. At birth, infected infants may have intracranial calcification, hydrocephalus, and retinochoroiditis, and new ocular lesions can occur at any age after birth. Not all children who acquire infection in utero develop these clinical signs of disease. Whilst severity of disease is influenced by trimester in which infection is acquired by the mother, other factors including genetic predisposition may contribute.In 457 mother-child pairs from Europe, and 149 child/parent trios from North America, we show that ocular and brain disease in congenital toxoplasmosis associate with polymorphisms in ABCA4 encoding ATP-binding cassette transporter, subfamily A, member 4. Polymorphisms at COL2A1 encoding type II collagen associate only with ocular disease. Both loci showed unusual inheritance patterns for the disease allele when comparing outcomes in heterozygous affected children with outcomes in affected children of heterozygous mothers. Modeling suggested either an effect of mother's genotype, or parent-of-origin effects. Experimental studies showed that both ABCA4 and COL2A1 show isoform-specific epigenetic modifications consistent with imprinting.These associations between clinical outcomes of congenital toxoplasmosis and polymorphisms at ABCA4 and COL2A1 provide novel insight into the molecular pathways that can be affected by congenital infection with this parasite.

Cardiac abnormalities in the acquired immunodeficiency syndrome. A prospective study with a clinical-pathological correlation in twenty-one adult patients

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Herdy Gesmar Volga Haddad

1999-01-01

Full Text Available OBJECTIVE - To evaluate the cardiac abnormalities and their evolution during the course of the acquired immunodeficiency syndrome, as well as to correlate clinical and pathological data. METHODS - Twenty-one patients, admitted to the hospital with the diagnosis of acquired immunodeficiency syndrome, were prospectively studied and followed until their death. Age ranged from 19 to 42 years (17 males. ECG and echocardiogram were also obtained every six months. After death, macro- and microscopic examinations were also performed. RESULTS - The most frequent causes of referral to the hospital were: diarrhea or repeated pneumonias, tuberculosis, toxoplasmosis or Kaposi sarcoma. The most frequent findings were acute or chronic pericarditis (42% and dilated cardiomyopathy (19%. Four patients died of cardiac problems: infective endocarditis, pericarditis with pericardial effusion, bacterial myocarditis and infection by Toxoplasma gondii. CONCLUSION - Severe cardiac abnormalities were the cause of death in some patients. In the majority of the patients, a good correlation existed between clinical and anatomical-pathological data. Cardiac evaluation was important to detect early manifestations and treat them accordingly, even in asymptomatic patients.

Cerebral toxoplasmosis in AIDS - computerized tomography evaluation

International Nuclear Information System (INIS)

Alves, Regina Coeli Fonseca; Narchiori, Edson

1999-01-01

Cerebral toxoplasmosis is a disease that affects many AIDS's patients. FOr this paper 46 patients with confirmed cases of cerebral toxoplasmosis who did a CT scan between March, 1994 and September, 1997 were examined. Single lesions were found in 28.3% of the patients. The lesions were more frequently detected in the basal ganglia and the frontal lobes. No lesion was larger than 4 cm. As regards the contrast enhancing of the lesions on a CT scan we observed that 54.5% of the lesions had a ring-like contrast enhancing, 36.4% had a nodular contrast enhancing and 6% had a heterogeneous form. After the 21st day of treatment we noticed an improvement in the aspect of the patients'lesions. The improvement of the lesions could be seen through a reduction of the edematous halo, a reduction of the lesion size and a modification in the contrast enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility with cerebral toxoplasmosis, as well as to monitor these patients during treatment. (author)

Aspectos neurológicos da toxoplasmose adquirida: estudo clínico-laboratorial e terapêutico de 8 casos Neurologic aspects of acquired toxoplasmosis: clinical, laboratorial and therapeutic study of eight cases

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J. Lamartine de Assis

1969-12-01

Full Text Available Foram revistos 62 casos com o diagnóstico de toxoplasmose, de pacientes internados nas Clínicas Neurológica e de Moléstias infecciosas do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo no período de 1958 a 1968, tendo sido encontrados 8 casos com provável comprometimento do sistema nervoso central pela toxoplasmose adquirida. Baseados nesses casos os autores fizeram um estudo clínico, laboratorial e terapêutico dessa neuroparasitose. Foi salientada a dificuldade do diagnóstico de certeza em virtude das manifestações neurológicas serem variáveis e inespecíficas, e a demonstração do parasito ser muito difícil nas formas nervosas da toxoplasmose adquirida. O diagnóstico foi admitido mediante os dados clínicos e laboratoriais, assim como pelos resultados do tratamento específico. Dentre os exames de laboratório foi salientada a reação de Sabin-Feldman, realizada no soro sangüíneo de todos os pacientes; apenas em dois casos esta reação foi feita no líquido cefalorraqueano; em 5 casos a prova sorológica foi repetida a intervalos variáveis de tempo; em um paciente foram realizadas as provas de imunofluorescência. Também foram valorizadas, para o diagnóstico, oscilações significantes das provas sorológicas. Foi considerada a positividade superior a 1/1000 como o limite de separação entre os casos de toxoplasmose-infecção e aqueles de toxoplasmose-doença. Os aspectos clinico-laboratoriais que fundamentaram o diagnóstico foram comentados e bem assim os métodos terapêuticos aplicados e seus resultados.A review is made of 62 cases with the diagnosis of toxoplasmosis studied in the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brasil, covering a period of 10 years (1958-1968, with 8 cases only of probable acquired toxoplasmosis of the nervous system. These 8 patients gave a basis for a clinical, laboratorial and therapeutic study. It was emphasized

Congenital toxoplasmosis and prenatal care state programs

Science.gov (United States)

2014-01-01

Background Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients. Methods We performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin. Results A total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection. Conclusion Treatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the

Acquired immunodeficiency syndrome in a patient with no known risk factors: a pathological study.

OpenAIRE

Burt, A D; Scott, G; Shiach, C R; Isles, C G

1984-01-01

We present the pathological findings in a case of acquired immunodeficiency syndrome (AIDS) in a patient with no known risk factor. Postmortem examination showed klebsiella lung abscess, generalised cytomegalovirus infection, cerebral toxoplasmosis, and a primary cerebral lymphoma. An additional feature was the presence of dilatation of the intrahepatic large bile ducts in association with an atypical distribution of cytomegalovirus. The relation between this case and previously reported case...

Human toxoplasmosis-Searching for novel chemotherapeutics.

Science.gov (United States)

Antczak, Magdalena; Dzitko, Katarzyna; Długońska, Henryka

2016-08-01

The protozoan Toxoplasma gondii, an obligate intracellular parasite, is an etiological agent of human and animal toxoplasmosis. Treatment regimens for T. gondii-infected patients have not essentially changed for years. The most common chemotherapeutics used in the therapy of symptomatic toxoplasmosis are a combination of pyrimethamine and sulfadiazine plus folinic acid or a combination of pyrimethamine with lincosamide or macrolide antibiotics. To protect a fetus from parasite transplacental transmission, therapy of pregnant women is usually based on spiramycin, which is quite safe for the organism, but not efficient in the treatment of infected children. Application of recommended drugs limits replication of T. gondii, however, it may be associated with numerous an severe adverse effects. Moreover, medicines have no impact on the tissue cysts of the parasite located predominantly in a brain and muscles. Thus, there is urgent need to develop new drugs and establish "gold standard" treatment. In this review classical treatment of toxoplasmosis as well as potential compounds active against T. gondii have been discussed. For two last decades studies on the development of new anti-T. gondii medications have been focused on both natural and novel synthetic compounds based on existing chemical scaffolds. They have revealed several promising drug candidates characterized by a high selectivity, the low IC50 (the half maximal inhibitory concentration) and low cytotoxicity towards host cells. These drugs are expected to replace or supplement current anti-T. gondii drug arsenal soon. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Cerebral toxoplasmosis mimicking subacute meningitis in HIV-infected patients; a cohort study from Indonesia.

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A Rizal Ganiem

Full Text Available BACKGROUND: HIV-associated subacute meningitis is mostly caused by tuberculosis or cryptococcosis, but often no etiology can be established. In the absence of CT or MRI of the brain, toxoplasmosis is generally not considered as part of the differential diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: We performed cerebrospinal fluid real time PCR and serological testing for Toxoplasma gondii in archived samples from a well-characterized cohort of 64 HIV-infected patients presenting with subacute meningitis in a referral hospital in Indonesia. Neuroradiology was only available for 6 patients. At time of presentation, patients mostly had newly diagnosed and advanced HIV infection (median CD4 count 22 cells/mL, with only 17.2% taking ART, and 9.4% PJP-prophylaxis. CSF PCR for T. Gondii was positive in 21 patients (32.8%. Circulating toxoplasma IgG was present in 77.2% of patients tested, including all in whom the PCR of CSF was positive for T. Gondii. Clinically, in the absence of neuroradiology, toxoplasmosis was difficult to distinguish from tuberculosis or cryptococcal meningitis, although CSF abnormalities were less pronounced. Mortality among patients with a positive CSF T. Gondii PCR was 81%, 2.16-fold higher (95% CI 1.04-4.47 compared to those with a negative PCR. CONCLUSIONS/SIGNIFICANCE: Toxoplasmosis should be considered in HIV-infected patients with clinically suspected subacute meningitis in settings where neuroradiology is not available.

First report of systemic toxoplasmosis in a New Zealand sea lion (Phocarctos hookeri).

Science.gov (United States)

Roe, W D; Michael, S; Fyfe, J; Burrows, E; Hunter, S A; Howe, L

2017-01-01

A 1-year-old female New Zealand sea lion (Phocarctos hookeri) was intermittently observed in the Otago region of New Zealand over an 11-month period, always dragging her hind flippers. In December 2012 the sea lion was found dead, after a period of several days being observed to be harassed by male sea lions. At gross postmortem examination the sea lion was in moderate body condition with signs of recent bite wounds and bruising. The lungs were dark and poorly inflated. Histological findings included meningoencephalomyelitis, radiculomyelitis of the cauda equina, myocarditis and myositis. Toxoplasmosis gondii organisms were detected histologically and following immunohistochemistry in the brain, spinal cord, spinal nerves and pelvic muscles. Nested PCR analysis and sequencing confirmed the presence of T. gondii DNA in uterine and lung tissue. A variant type II T. gondii genotype was identified using multilocus PCR-restriction fragment length polymorphism analysis. Systemic toxoplasmosis. Infection with T. gondii involving the spinal cord and nerves was the likely cause of the paresis observed in this sea lion before death. Ultimately, death was attributed to crushing and asphyxiation by a male sea lion, presumably predisposed by impaired mobility. Diagnosis of toxoplasmosis in a New Zealand sea lion highlights the possibility that this disease could play a role in morbidity and mortality in this endangered species, particularly in the recently established mainland populations that are close to feline sources of T. gondii oocysts.

Toxoplasmosis in three species of native and introduced Hawaiian birds

Science.gov (United States)

Work, Thierry M.; Massey, J. Gregory; Lindsay, D.S.; Dubey, J.P.

2002-01-01

Toxoplasma gondii was found in endemic Hawaiian birds, including 2 nene geese (Nesochen sandvicensis), 1 red-footed booby (Sula sula), and an introduced bird, the Erckels francolin (Francolinus erckelii). All 4 birds died of disseminated toxoplasmosis; the parasite was found in sections of many organs, and the diagnosis was confirmed by immunohistochemical staining with anti–T. gondii–specific polyclonal antibodies. This is the first report of toxoplasmosis in these species of birds.

Long term ocular and neurological involvement in severe congenital toxoplasmosis.

OpenAIRE

Meenken, C; Assies, J; van Nieuwenhuizen, O; Holwerda-van der Maat, W G; van Schooneveld, M J; Delleman, W J; Kinds, G; Rothova, A

1995-01-01

AIMS--This study was set up to determine the long term ocular and systemic sequelae in patients with severe congenital toxoplasmosis. METHODS--Cross sectional and retrospective study of 17 patients with severe congenital toxoplasmosis. RESULTS--In addition to chorioretinitis (100%), the most common abnormal ocular features were optic nerve atrophy (83%), visual acuity of less than 0.1 (85%), strabismus, and microphthalmos. In 50% of cases we observed iridic abnormalities and about 40% develop...

Vaccination with Recombinant Microneme Proteins Confers Protection against Experimental Toxoplasmosis in Mice.

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Camila Figueiredo Pinzan

Full Text Available Toxoplasmosis, a zoonotic disease caused by Toxoplasma gondii, is an important public health problem and veterinary concern. Although there is no vaccine for human toxoplasmosis, many attempts have been made to develop one. Promising vaccine candidates utilize proteins, or their genes, from microneme organelle of T. gondii that are involved in the initial stages of host cell invasion by the parasite. In the present study, we used different recombinant microneme proteins (TgMIC1, TgMIC4, or TgMIC6 or combinations of these proteins (TgMIC1-4 and TgMIC1-4-6 to evaluate the immune response and protection against experimental toxoplasmosis in C57BL/6 mice. Vaccination with recombinant TgMIC1, TgMIC4, or TgMIC6 alone conferred partial protection, as demonstrated by reduced brain cyst burden and mortality rates after challenge. Immunization with TgMIC1-4 or TgMIC1-4-6 vaccines provided the most effective protection, since 70% and 80% of mice, respectively, survived to the acute phase of infection. In addition, these vaccinated mice, in comparison to non-vaccinated ones, showed reduced parasite burden by 59% and 68%, respectively. The protective effect was related to the cellular and humoral immune responses induced by vaccination and included the release of Th1 cytokines IFN-γ and IL-12, antigen-stimulated spleen cell proliferation, and production of antigen-specific serum antibodies. Our results demonstrate that microneme proteins are potential vaccines against T. gondii, since their inoculation prevents or decreases the deleterious effects of the infection.

Vaccination with Recombinant Microneme Proteins Confers Protection against Experimental Toxoplasmosis in Mice.

Science.gov (United States)

Pinzan, Camila Figueiredo; Sardinha-Silva, Aline; Almeida, Fausto; Lai, Livia; Lopes, Carla Duque; Lourenço, Elaine Vicente; Panunto-Castelo, Ademilson; Matthews, Stephen; Roque-Barreira, Maria Cristina

2015-01-01

Toxoplasmosis, a zoonotic disease caused by Toxoplasma gondii, is an important public health problem and veterinary concern. Although there is no vaccine for human toxoplasmosis, many attempts have been made to develop one. Promising vaccine candidates utilize proteins, or their genes, from microneme organelle of T. gondii that are involved in the initial stages of host cell invasion by the parasite. In the present study, we used different recombinant microneme proteins (TgMIC1, TgMIC4, or TgMIC6) or combinations of these proteins (TgMIC1-4 and TgMIC1-4-6) to evaluate the immune response and protection against experimental toxoplasmosis in C57BL/6 mice. Vaccination with recombinant TgMIC1, TgMIC4, or TgMIC6 alone conferred partial protection, as demonstrated by reduced brain cyst burden and mortality rates after challenge. Immunization with TgMIC1-4 or TgMIC1-4-6 vaccines provided the most effective protection, since 70% and 80% of mice, respectively, survived to the acute phase of infection. In addition, these vaccinated mice, in comparison to non-vaccinated ones, showed reduced parasite burden by 59% and 68%, respectively. The protective effect was related to the cellular and humoral immune responses induced by vaccination and included the release of Th1 cytokines IFN-γ and IL-12, antigen-stimulated spleen cell proliferation, and production of antigen-specific serum antibodies. Our results demonstrate that microneme proteins are potential vaccines against T. gondii, since their inoculation prevents or decreases the deleterious effects of the infection.

Hyperthyroidism caused by acquired immune deficiency syndrome.

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Wang, J-J; Zhou, J-J; Yuan, X-L; Li, C-Y; Sheng, H; Su, B; Sheng, C-J; Qu, S; Li, H

2014-01-01

Acquired immune deficiency syndrome (AIDS) is an immune deficiency disease. The etiology of hyperthyroidism, which can also be immune-related, is usually divided into six classical categories, including hypophyseal, hypothalamic, thyroid, neoplastic, autoimmune and inflammatory hyperthyroidism. Hyperthyroidism is a rare complication of highly active antimicrobial therapy (HAART) for human immunodeficiency virus (HIV). Hyperthyroidism caused directly by AIDS has not been previously reported. A 29-year-old man who complained of dyspnea and asthenia for 1 month, recurrent fever for more than 20 days, and breathlessness for 1 week was admitted to our hospital. The thyroid function test showed that the level of free thyroxine (FT4) was higher than normal and that the level of thyroid-stimulating hormone (TSH) was below normal. He was diagnosed with hyperthyroidism. Additional investigations revealed a low serum albumin level and chest infection, along with diffuse lung fibrosis. Within 1 month, he experienced significant weight loss, no hand tremors, intolerance of heat, and perspiration proneness. We recommended an HIV examination; subsequently, AIDS was diagnosed based on the laboratory parameters. This is the first reported case of hyperthyroidism caused by AIDS. AIDS may cause hyperthyroidism by immunization regulation with complex, atypical, and easily ignored symptoms. Although hyperthyroidism is rare in patients with AIDS, clinicians should be aware of this potential interaction and should carefully monitor thyroid function in HIV-positive patients.

Listeriosis and Toxoplasmosis in Pregnancy: Essentials for Healthcare Providers.

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Pfaff, Nicole Franzen; Tillett, Jackie

2016-01-01

Listeriosis and toxoplasmosis are foodborne illnesses that can have long-term consequences when contracted during pregnancy. Listeriosis is implicated in stillbirth, preterm labor, newborn sepsis, and meningitis, among other complications. Toxoplasmosis is associated with blindness, cognitive delays, seizures, and hearing loss, among other significant disabilities. Healthcare providers who understand the fundamentals of Listeria and Toxoplasma infection will have the tools to identify symptoms and high-risk behaviors, educate women to make safer decisions, and provide anticipatory guidance if a pregnant woman would become infected with either of these foodborne illnesses.

Unexpected Diagnosis of Cerebral Toxoplasmosis by 16S and D2 Large-Subunit Ribosomal DNA PCR and Sequencing

DEFF Research Database (Denmark)

Kruse, Alexandra Yasmin Collin; Kvich, Lasse Andersson; Eickhardt-Dalbøge, Steffen Robert

2015-01-01

The protozoan parasite Toxoplasma gondii causes severe opportunistic infections. Here, we report an unexpected diagnosis of cerebral toxoplasmosis. T. gondii was diagnosed by 16S and D2 large-subunit (LSU) ribosomal DNA (rDNA) sequencing of a cerebral biopsy specimen and confirmed by T. gondii...

Blimp-1–mediated CD4 T cell exhaustion causes CD8 T cell dysfunction during chronic toxoplasmosis

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Cobb, Dustin A.; Bhadra, Rajarshi

2016-01-01

CD8, but not CD4, T cells are considered critical for control of chronic toxoplasmosis. Although CD8 exhaustion has been previously reported in Toxoplasma encephalitis (TE)–susceptible model, our current work demonstrates that CD4 not only become exhausted during chronic toxoplasmosis but this dysfunction is more pronounced than CD8 T cells. Exhausted CD4 population expressed elevated levels of multiple inhibitory receptors concomitant with the reduced functionality and up-regulation of Blimp-1, a transcription factor. Our data demonstrates for the first time that Blimp-1 is a critical regulator for CD4 T cell exhaustion especially in the CD4 central memory cell subset. Using a tamoxifen-dependent conditional Blimp-1 knockout mixed bone marrow chimera as well as an adoptive transfer approach, we show that CD4 T cell–intrinsic deletion of Blimp-1 reversed CD8 T cell dysfunction and resulted in improved pathogen control. To the best of our knowledge, this is a novel finding, which demonstrates the role of Blimp-1 as a critical regulator of CD4 dysfunction and links it to the CD8 T cell dysfunctionality observed in infected mice. The critical role of CD4-intrinsic Blimp-1 expression in mediating CD4 and CD8 T cell exhaustion may provide a rational basis for designing novel therapeutic approaches. PMID:27481131

Cerebral involvement in acquired immunodeficiency syndrome (AIDS)

International Nuclear Information System (INIS)

Krestin, G.P.; Juergens, R.; Steinbrich, W.; Diederich, N.; Koeln Univ.

1986-01-01

Involvement of the central nervous system in acquired immune deficiency syndrome (AIDS) is usually due to opportunistic infections; these frequently offer a difficult differential diagnostic problem. Imaging methods play an important part in the elucidation of symptoms. CT and MR findings were analysed in 13 patients with AIDS and neurological symptoms. Some infections of the central nervous system (encephalitis of unknown aetiology, cytomegalic encephalitis, meningitis) may show cerebral atrophy or even no morphological changes. Toxoplasmosis and PML are the most common opportunistic infections typical changes on CT and MR may lead to diagnosis. MR offers advantages compared with CT in its higher sensitivity for the demonstration even of small lesions. (orig.) [de

Acquired immunodeficiency syndrome in a patient with no known risk factors: a pathological study.

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Burt, A D; Scott, G; Shiach, C R; Isles, C G

1984-04-01

We present the pathological findings in a case of acquired immunodeficiency syndrome (AIDS) in a patient with no known risk factor. Postmortem examination showed klebsiella lung abscess, generalised cytomegalovirus infection, cerebral toxoplasmosis, and a primary cerebral lymphoma. An additional feature was the presence of dilatation of the intrahepatic large bile ducts in association with an atypical distribution of cytomegalovirus. The relation between this case and previously reported cases of AIDS is discussed.

Cerebral toxoplasmosis in Danish AIDS patients

DEFF Research Database (Denmark)

Smith, E; Pers, C; Aschow, C

1991-01-01

We estimate the frequency of central nervous system (CNS) toxoplasmosis in Danish AIDS patients and evaluate the diagnostic accuracy using the following criteria for acceptance of the diagnosis: either (1) the demonstration of Toxoplasma gondii in brain tissue or (2) one or more hypodense or ring......-enhancing lesions on computerized axial tomography (CAT) scan and a neurologic and CAT scan improvement in response to 2 weeks of treatment. From 1981 until July 1990 266 patients were diagnosed with AIDS at Hvidovre Hospital, Copenhagen and 29 (11%) were treated, suspected for CNS toxoplasmosis. 17 patients had...... the diagnosis confirmed but since 5 patients, who were never treated, were diagnosed at autopsy, the overall cumulated incidence was 8% (22/266 patients). The overall diagnostic accuracy was 59% (17/29 patients) showing some changes over time. Among patients diagnosed with AIDS in 1988 or later, the accuracy...

First case report of M1 macrophage polarization in an untreated symptomatic patient with toxoplasmosis.

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De Luca, Graziano; Di Lisio, Chiara; Lattanzio, Giuseppe; D'Antuono, Tommaso; Liberatore, Marcella; Aiello, Francesca Bianca

2018-03-27

In immunocompetent patients, acute toxoplasmosis is usually asymptomatic. We identified M1 macrophages in a case of symptomatic acute Toxoplasma gondii infection that resolved without treatment. M1 macrophages have been demonstrated in animal models of toxoplasmosis, but not in humans. A 63-year-old woman presented with laterocervical and axillary bilateral lymphadenopathy. Her anamnesis defined an episode of high fever and prolonged asthenia 4 months previously, which suggested an infectious disease. Following laboratory, radiological, and pathological analyses, she was diagnosed with toxoplasmosis. Immunohistochemical analyses were performed on lymph node sections. More than 50% of the macrophages in the lymph node microgranulomas were M1 macrophages, defined by CD68 + /p-Stat1 + staining, and the presence of T helper 1 lymphocytes indicated an immune response known to induce M1 macrophage polarization. Activated endothelial cells were found only in inflamed areas. No therapy was administered before or after diagnosis, and the lymphadenopathy resolved after a follow-up of 5 months. This is the first report to demonstrate the presence of M1 macrophages in human toxoplasmosis. Our findings contribute to the understanding of the pathogenesis of toxoplasmosis, and encourage further studies on the role of macrophage polarization in human toxoplasmosis.

Serological Survey of Toxoplasmosis Transvaal

African Journals Online (AJOL)

Serological Survey of Toxoplasmosis. Transvaal. P. R. MASON, M. R. JACOBS, P. J. FRIPP. •. In the. SUMMARY. Thirty-seven per cent of 605 samples of human sera col- lected from four ethnic groups in South Africa gave a positive Toxoplasma indir~ct fluorescent antibody test at a dilution 01 1/16 or higher. The incidences ...

[Increasing incidence of community-acquired pneumonia caused by atypical microorganisms].

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Tazón-Varela, M A; Alonso-Valle, H; Muñoz-Cacho, P; Gallo-Terán, J; Piris-García, X; Pérez-Mier, L A

2017-09-01

Knowing the most common microorganisms in our environment can help us to make proper empirical treatment decisions. The aim is to identify those microorganisms causing community-acquired pneumonia. An observational, descriptive and prospective study was conducted, including patients over 14 years with a clinical and radiographic diagnosis of community-acquired pneumonia during a 383 consecutive day period. A record was made of sociodemographic variables, personal history, prognostic severity scales, progress, and pathogenic agents. The aetiological diagnosis was made using blood cultures, detection of Streptococcus pneumoniae and Legionella pneumophila urinary antigens, sputum culture, influenza virus and Streptococcus pyogenes detection. Categorical variables are presented as absolute values and percentages, and continuous variables as their means and standard deviations. Of the 287 patients included in the study (42% women, mean age 66±22 years), 10.45% died and 70% required hospital admission. An aetiological diagnosis was achieved in 43 patients (14.98%), with 16 microorganisms found in 59 positive samples. The most frequently isolated pathogen was Streptococcus pneumonia (24/59, 41%), followed by gram-negative enteric bacilli, Klebsiella pneumonia, Escherichia coli, Serratia marcescens and Enterobacter cloacae isolated in 20% of the samples (12/59), influenza virus (5/59, 9%), methicillin-resistant Staphylococcus aureus (3/59, 5%), Pseudomonas aeruginosa (2/59, 3%), Moraxella catarrhalis (2/59, 3%), Legionella pneumophila (2/59, 3%), and Haemophilus influenza (2/59, 3%). Polymicrobial infections accounted for 14% (8/59). A high percentage of atypical microorganisms causing community-acquired pneumonia were found. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

Corticosteroids as adjuvant therapy for ocular toxoplasmosis.

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Jasper, Smitha; Vedula, Satyanarayana S; John, Sheeja S; Horo, Saban; Sepah, Yasir J; Nguyen, Quan Dong

2017-01-26

Ocular infection caused by Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea, and consequently lead to complications such as glaucoma, cataract, and posterior synechiae. The objective of this systematic review was to assess the effects of adjunctive use of corticosteroids to anti-parasitic therapy versus anti-parasitic therapy alone for ocular toxoplasmosis. We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register (2016; Issue 11)), MEDLINE Ovid, Epub Ahead of Print, In-Process & Other Non-Indexed Citations, MEDLINE Ovid Daily (January 1946 to December 2016), Embase (January 1980 to December 2016), Latin American and Caribbean Literature on Health Sciences (LILACS (January 1982 to December 2016)), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov), and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP; www.who.int/ictrp/search/en). We used no date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 7 December 2016. We had planned to include randomized and quasi-randomized controlled trials. Eligible trials would have enrolled participants of any age who were immunocompetent and were diagnosed with acute ocular toxoplasmosis. Included trials would have compared anti-parasitic therapy plus corticosteroids versus anti-parasitic therapy alone, different doses or times of initiation of corticosteroids. Two authors independently screened titles and abstracts retrieved through the electronic searches. We retrieved full-text reports of studies categorized as 'unsure' or 'include' after we reviewed the abstracts. Two authors independently reviewed each full-text report for eligibility. Discrepancies were resolved through discussion. We identified no completed or ongoing trial that was eligible for this Cochrane review. Although research has identified a wide

Serodiagnosis of Toxoplasmosis: The effect of measurement of IgG avidity in pregnant women in Rabat in Morocco.

Science.gov (United States)

Laboudi, Majda; Sadak, Abderrahim

2017-08-01

The diagnosis of Toxoplasmosis in pregnant women during the early first trimester of pregnancy is very important for preventing congenital infection of the fetus; it will not only prevent the risk of transmitting the infection to the fetus but it will also enable to give these women a preventive treatment. In this study, the avidity test was performed on pregnant women during their first prenatal visit at the National Institute of Hygiene in Rabat, Morocco. One hundred and twenty-eight sera samples were collected from 128 pregnant women between August 2015 and June 2016; these women were chosen retrospectively and were in their first four months of pregnancy. The samples were screened using the specific anti-Toxoplasma IgG and IgM antibodies and were subjected to an IgG avidity test. After the serological screening, only 54 women (42.4%) were tested positive for IgG antibodies and five women (3.9%) were tested positive for both anti-Toxoplasma IgG and IgM antibodies. Four IgM-negative women had low-avidity antibodies. However, none of the IgG-avidity test had detected low-avidity antibodies in the five IgM-positive women; three women (60%) had high-avidity antibodies, indicating that the infection was acquired in the distant past. The avidity test is a helpful tool to exclude a recently acquired toxoplasmosis infection within IgM-positive serum samples in pregnant women during their first trimester of pregnancy. Thus, allowing to perform an appropriate therapeutic intervention. Copyright © 2017 Elsevier B.V. All rights reserved.

Long term ocular and neurological involvement in severe congenital toxoplasmosis.

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Meenken, C; Assies, J; van Nieuwenhuizen, O; Holwerda-van der Maat, W G; van Schooneveld, M J; Delleman, W J; Kinds, G; Rothova, A

1995-06-01

This study was set up to determine the long term ocular and systemic sequelae in patients with severe congenital toxoplasmosis. Cross sectional and retrospective study of 17 patients with severe congenital toxoplasmosis. In addition to chorioretinitis (100%), the most common abnormal ocular features were optic nerve atrophy (83%), visual acuity of less than 0.1 (85%), strabismus, and microphthalmos. In 50% of cases we observed iridic abnormalities and about 40% developed a cataract. Overt endocrinological disease, diagnosed in five of 15 patients, included panhypopituitarism (n = 2), gonadal failure with dwarfism (n = 1), precocious puberty with dwarfism and thyroid deficiency (n = 1), and diabetes mellitus and thyroid deficiency (n = 1). The observed endocrinological involvement was associated in all cases with obstructive hydrocephalus with a dilated third ventricle and optic nerve atrophy. The recognition of long term ocular, neurological, and endocrinological sequelae of congenital toxoplasmosis is important for medical management of these severely handicapped patients.

Influence of indigenous microbiota on experimental toxoplasmosis in conventional and germ-free mice.

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Nascimento, Bruna B; Cartelle, Christiane T; Noviello, Maria de L; Pinheiro, Breno V; de Almeida Vitor, Ricardo W; Souza, Danielle da G; de Vasconcelos Generoso, Simone; Cardoso, Valbert N; Martins, Flaviano Dos S; Nicoli, Jacques R; Arantes, Rosa M E

2017-08-01

Toxoplasmosis represents one of the most common zoonoses worldwide. Its agent, Toxoplasma gondii, causes a severe innate pro-inflammatory response. The indigenous intestinal microbiota promotes host animal homoeostasis and may protect the host against pathogens. Germ-free (GF) animals provide an important tool for the study of interactions between host and microbiota. In this study, we assessed the role of indigenous microorganisms in disease development utilizing a murine toxoplasmosis model, which includes conventional (CV) and GF NIH Swiss mice. CV and GF mice orally inoculated with T. gondii had similar survival curves. However, disease developed differently in the two animal groups. In CV mice, intestinal permeability increased and levels of intestinal pro-inflammatory cytokines were altered. In GF animals, there were discrete epithelial degenerative changes and mucosal oedema, but the liver and lungs displayed significant lesions. We conclude that, despite similar survival curves, CV animals succumb to an exaggerated inflammatory response, whereas GF mice fail to produce an adequate systemic response. © 2017 The Authors. International Journal of Experimental Pathology © 2017 International Journal of Experimental Pathology.

The prevalence of toxoplasmosis in Imam Reza Hospital blood bank samples, Tehran, Iran.

Science.gov (United States)

Shaddel, M; Mirzaii Dizgah, I; Sharif, F

2014-10-01

The prevalence of toxoplasma gondii (T.g) infection in blood donors has been poorly studied. The aim of this study was to assess the prevalence of acute and chronic toxoplasmosis in blood products. A total of 223 blood products (101 fresh frozen plasma (FFP) and 122 packed cells (PC)) in Imam Reza hospital blood bank, Tehran, Iran were tested for specific T.g antibodies (IgG and IgM) by ELISA method. Positive IgG anti-T.g samples were further tested for IgM anti-T.g. A positive IgG test with the negative and positive IgM test was interpreted as a chronic and acute toxoplasmosis respectively. Of 223 samples 38.6% and 0.45% were positive for IgG anti-T.g and IgM anti-T.g levels respectively. Therefore, one and 85 samples were involved acute and chronic toxoplasmosis respectively. Twenty-six of fresh frozen plasma samples were positive for IgG anti-T.g and one of them was positive for IgM anti-T.g. Sixty packed cell samples were positive for IgG anti-T.g. Our study showed that there were chronic and acute toxoplasmosis in blood products and the prevalence of toxoplasmosis especially chronic form was high. Therefore screening of blood for T.g antibodies may be considered. Copyright © 2014 Elsevier Ltd. All rights reserved.

Seroepidemiology of human toxoplasmosis in Chile Seroepidemiología de la toxoplasmosis en Chile

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Maria del C. Contreras

1996-12-01

Full Text Available A series of already published and unpublished seroepidemiological surveys for toxoplasmosis, carried out in Chile in 1982-1994, is reviewed, expanded and analyzed. The surveys included 76,317 apparently healthy individuals of different ages (0.57% of the country's total population, from 309 urban and rural-periurban localities. Urban groups were integrated by blood donors, delivering mothers and middle grade schoolchildren, while rural-periurban individuals corresponded to unselected family groups. Blood samples were collected in filter paper. The presence of antibodies to Toxoplasma gondii was determined by the indirect hemagglutination test (IHAT, titers > 16 were considered positive. The test resulted positive in 28,124 (36.9% of the surveyed people. Two hundred and six (0.3% individuals presented IHAT titers > 1000, probably corresponding to acute or reactivated infections. A progressive increase of positive IHAT from northern to southern regions of the country was noted, phenomenom probably related to geographical conditions and to a higher production and consumption of different types of meat in the latter regions. It is postulated that ingestion of T. gondii cysts by humans is epidemiologically as important as ingestion of oocysts. The results presented stress the epidemiological importance of toxoplasmosis in humans, and warn about eventual implications in immunocompromised patients and in transplacental transmission, organ transplants and transfusions.En este trabajo se revisa, se amplía y se analiza en conjunto una serie de encuestas seroepidemiológicas sobre toxoplasmosis efectuadas en Chile entre 1982 y 1994, utilizando la reacción de hemaglutinación indirecta (RHAI. El estudio incluyó 76.317 personas aparentemente sanas de diferentes edades (0,57% de la problación total del país, procedentes de 309 localidades urbanas y rural-periurbanas. Los grupos urbanos estuvieron constituídos por donantes de sangre, parturientas y

Diagnosis of acute toxoplasmosis in pregnant women referred to therapeutic centers of Alborz Province (Iran using immunoglobulin G avidity ELISA technique

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Lame Akhlaghi

2016-11-01

Full Text Available Objective: To evaluate immunoglobulin G (IgG avidity as a useful and reliable technique in diagnosing toxoplasmosis in pregnant women referring to therapeutic centers of Alborz Province (Iran in 2014, against two other tests, IgG and immunoglobulin G (IgM antiToxoplasma. Methods: Serum samples (468 in total were obtained from different therapeutic centers in Karaj City. ELISA method was used to test the anti-Toxoplasma avidity of IgG, IgM and IgG. The data were analyzed by descriptive statistical methods and Chi-square test (P < 0.05 using SPSS 17.0. Results: Anti-Toxoplasma tests of IgM and IgG were positive in 9 and 86 samples respectively. Also, a borderline IgM was detected in 2 suspected samples. In addition, among all positive and suspected samples, 79 cases indicated high titers of IgG avidity, 7 cases were of low titers and 1 case was of a borderline titer. The prevalence of anti-Toxoplasma antibodies was 20%. The sera which showed high avidity index was obtained from patients at chronic phase of infection (92% while those which showed low avidity levels were from patients at acute toxoplasmosis (77.7%. Conclusions: This study clearly showed that acute and chronic phases of toxoplasmosis could be differentiated with the aid of IgG avidity test. This test may also assist in recognizing old and newly acquired infections.

Is there any role of latent toxoplasmosis in schizophrenia disease?

Science.gov (United States)

Karabulut, Nuran; Bilgiç, Serkan; Gürok, Mehmet Gürkan; Karaboğa, Fatih

2015-09-01

A large number of studies have hypothesized that Toxoplasma gondii is a potentially relevant etiological factor in some cases of schizophrenia. By contrast, some studies have disproved this association. The aim of this study was to investigate whether latent toxoplasmosis has any role in schizophrenia disease. Additionally, the association between T. gondii and subtypes of schizophrenia, and the impacts of toxoplasmosis on psychopathology were examined in the study. A total of 85 patients with schizophrenia and 60 healthy volunteers were included in this prospective study. Immunoglobulin G (IgG) antibody to T. gondii was examined by enzyme-linked immune-sorbent assay method. Seropositivity rates were 43.5% for the patients with schizophrenia and 43.3% for the healthy controls (odds ratio: 1.008, 95% confidence interval: 0.517-1.964, p = 0.981).There was no significant difference in T. gondii IgG positivity between the schizophrenia and control groups with respect to sex and age. The difference in seroprevalence of T. gondii IgG antibodies among the schizophrenia subtypes was not statistically significant (p = 0.934). No significant difference was found in Positive and Negative Syndrome Subscales between Toxoplasma-infected and Toxoplasma-free patients. In the study area with a high prevalence of T. gondii, no association between toxoplasmosis and schizophrenia was detected. These findings showed that toxoplasmosis has no role in the risk of schizophrenia disease. Copyright © 2015. Published by Elsevier Taiwan.

Help in the Choice of Automated or Semiautomated Immunoassays for Serological Diagnosis of Toxoplasmosis: Evaluation of Nine Immunoassays by the French National Reference Center for Toxoplasmosis.

Science.gov (United States)

Villard, O; Cimon, B; L'Ollivier, C; Fricker-Hidalgo, H; Godineau, N; Houze, S; Paris, L; Pelloux, H; Villena, I; Candolfi, E

2016-12-01

Toxoplasmosis, a benign infection, is asymptomatic or paucisymptomatic in over 80% of cases, except in immunocompetent patients suffering from ocular toxoplasmosis or in immunocompromised patients with opportunistic or congenital toxoplasmosis. Diagnosis is based mainly on serology testing. Thus, we compared the performance of the nine most commonly used commercial automated or semiautomated immunoassays for IgG and IgM Toxoplasma gondii antibody detection, that is, the Advia Centaur, Architect, AxSYM, Elecsys, Enzygnost, Liaison, Platelia, VIDAS, and VIDIA assays. The assays were conducted on four panels of serum samples derived during routine testing from patients with an interfering disease and who exhibited a low IgG antibody level in one of two clinical settings, namely, acute or chronic toxoplasmosis. As a result, IgG sensitivities ranged from 97.1% to 100%, and IgG specificities ranged from 99.5% to 100%. For IgG quantification, strong differences in IgG titers (expressed in IU/ml) were noted depending on the assay used. IgM sensitivities ranged from 65% to 97.9%, and IgM specificities ranged from 92.6% to 100%. For defining the best serological strategies to be implemented, it appears crucial to compare the diagnostic performance of the different tests with respect to their specificity and sensitivity in detecting the presence of IgG and IgM antibodies. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Toxoplasmosis in at-risk groups of patients

Czech Academy of Sciences Publication Activity Database

Kučerová, Petra; Červinková, Monika

2016-01-01

Roč. 27, č. 1 (2016), s. 13-19 ISSN 0954-139X R&D Projects: GA MŠk ED2.1.00/03.0124 Institutional support: RVO:67985904 Keywords : congenital toxoplasmosis * immunosuppression * infection Subject RIV: EE - Microbiology, Virology

Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe.

Directory of Open Access Journals (Sweden)

Ruth E Gilbert

2008-08-01

Full Text Available Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America.We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.Three hundred and eleven (311 children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10% and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08. Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001. In Brazil, visual impairment (<6/12 Snellen was predicted for most affected eyes (87%, 27/31, but not in Europe (29%; 20/69, p<0.0001. The size of newly detected lesions decreased with age (p = 0.0007.T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.

Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe.

Science.gov (United States)

Gilbert, Ruth E; Freeman, Katherine; Lago, Eleonor G; Bahia-Oliveira, Lilian M G; Tan, Hooi Kuan; Wallon, Martine; Buffolano, Wilma; Stanford, Miles R; Petersen, Eskild

2008-08-13

Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America. We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents. Three hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001). In Brazil, visual impairment (<6/12 Snellen) was predicted for most affected eyes (87%, 27/31), but not in Europe (29%; 20/69, p<0.0001). The size of newly detected lesions decreased with age (p = 0.0007). T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.

Fatal disseminated toxoplasmosis in a zoological collection of meerkats (Suricata suricatta

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Monica Burger

2017-03-01

Full Text Available Two confirmed cases of fatal disseminated toxoplasmosis occurred in an urban zoological collection of meerkats (Suricata suricatta. Both cases are suspected to be the result of feral cats gaining access to the enclosure. Toxoplasmosis has rarely been documented in meerkats. Subsequent to prophylactic treatment of all the animals and structural changes being implemented within the enclosure, no new cases have been recorded to date. Very little information is available on the disease in viverrids.

Agreement between ultrasonography and computed tomography in detecting intracranial calcifications in congenital toxoplasmosis

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Lago, E.G. [Department of Pediatrics, Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Sao Lucas Hospital, Porto Alegre (Brazil)], E-mail: eglago@pucrs.br; Baldisserotto, M.; Hoefel Filho, J.R.; Santiago, D. [Department of Radiology, Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Sao Lucas Hospital, Porto Alegre (Brazil); Jungblut, R. [Department of Pediatrics, Pontificia Universidade Catolica do Rio Grande do Sul School of Medicine, Sao Lucas Hospital, Porto Alegre (Brazil)

2007-10-15

Aim: To evaluate the agreement between ultrasound (US) and computed tomography (CT) in detecting intracranial calcification in infants with congenital toxoplasmosis. Materials and methods: Forty-four infants referred for investigation of congenital toxoplasmosis were prospectively evaluated, and the diagnosis was confirmed or ruled out by serological testing and by follow-up in the first year of life. The investigation protocol included cranial US and cranial CT, and examinations were conducted and interpreted by two radiologists blinded to the results of the other imaging test and to the diagnostic confirmation. Results: The diagnosis of congenital toxoplasmosis was confirmed in 33 patients, and agreement between US and CT findings was found in 31 of these cases. Both methods detected calcifications in 18 patients, and neither detected calcifications in 13 patients. Overall agreement was 94% and the kappa coefficient was 0.88 (95% confidence interval: 0.71, 1; p < 0.001), which revealed almost perfect agreement between the two diagnostic methods. Conclusion: In this study, US and CT demonstrated equal sensitivity in the detection of intracranial calcification in infants with congenital toxoplasmosis.

Congenital toxoplasmosis presenting as central diabetes insipidus in an infant: a case report.

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Mohamed, Sarar; Osman, Abdaldafae; Al Jurayyan, Nasir A; Al Nemri, Abdulrahman; Salih, Mustafa A M

2014-03-28

Congenital toxoplasmosis has a wide range of presentation at birth varying from severe neurological features such as hydrocephalus and chorioretinitis to a well appearing baby, who may develop complications late in infancy. While neuroendocrine abnormalities associated with congenital toxoplasmosis are uncommon, isolated central diabetes insipidus is extremely rare. Here, we report on a female infant who presented with fever, convulsions, and polyuria. Examination revealed weight and length below the 3rd centile along with signs of severe dehydration. Fundal examination showed bilateral chorioretinitis. This infant developed hypernatremia together with increased serum osmolality and decreased both urine osmolality and specific gravity consistent with central diabetes insipidus. Serology for toxoplasma specific immunoglobulin M was high for both the mother and the baby and polymerase chain reaction for toxoplasma deoxyribonucleic acid was positive in the infant confirming congenital toxoplasmosis. Brain computerized tomography scans demonstrated ventriculomegaly associated with cerebral and cortical calcifications. Fluid and electrolyte abnormalities responded to nasal vasopressin therapy. This report highlights central diabetes inspidus as a rare presentation of congenital toxoplasmosis.

Clinical and morphological characteristics of malformations in infants with congenital cytomegalovirus infection and congenital toxoplasmosis

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L. Yu. Barycheva

2015-01-01

Full Text Available The results of following up infants with intrauterine infections and malformations were retrospectively analyzed. Infants with malformations were diagnosed as having congenital cytomegalovirus infection and congenital toxoplasmosis in 127 and 69 cases, respectively. The aim of the study was to characterize malformations in infants with congenital cytomegalovirus and congenital Toxoplasma infections. The infants with malformations in congenital cytomegalovirus infection were found to have higher mortality rates (61,4% than those with congenital toxoplasmosis (34,8%. Postmortem analysis indicated that there was a predominance of embryopathies in infants with congenital cytomegalovirus infection and that of fetopathies in those with congenital toxoplasmosis. The dead infants with congenital cytomegalovirus infection had more commonly developed visceral defects, including heart diseases, pneumopathies, gastrointestinal and genitourinary abnormalities; fetopathies of the central nervous system and eye were prevalent in congenital toxoplasmosis. The surviving children with congenital toxoplasmosis were more frequently observed to have disabling CNS and ocular sequels as obstructive hydrocephalus, infantile cerebral palsy, complete or partial blindness, and cerebrasthenic disorders than those with congenital cytomegalovirus infection. 

[Effect of antenatal spiramycin treatment on the frequency of retinochoroiditis due to congenital toxoplasmosis in a Colombian cohort].

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Zuluaga, Liliana María; Hernández, John Camilo; Castaño, Carlos Felipe; Donado, Jorge Hernando

2017-04-01

Gestational toxoplasmosis is frequent and severe. There is still debate about the benefits of treatment against ocular manifestations in the newborn. Spiramycin treatment is used for this purpose, unfortunately prenatal diagnosis is sometimes delayed and pregnant women are not treated. To describe the relationship between treatment with spiramycin during pregnancy in mothers with gestational toxoplasmosis and development of ocular toxoplasmosis in newborns. We conducted a descriptive study of a case series. We evaluated a prospective cohort of patients diagnosed with gestational toxoplasmosis during three years at the Retinology Service at the Clínica Universitaria Bolivariana in Medellín. Gestational toxoplasmosis was found in 23 mothers; 15 (65%) were treated during pregnancy with 3 g per day of spiramycin, eight (35%) patients were untreated. In the treated group just one newborn developed ocular toxoplasmosis (6.6%), in contrast with five (62.5%) of the eight patients who did not receive treatment. These results suggest that pregnancy treatment reduces the relative risk of ocular toxoplasmosis in the newborn by 96% (95% CI: 33 - 100%). Only two (14%) of the patients who were evaluated, had nervous system involvement related to toxoplasmosis in CT scan or cerebral ultrasound. These two patients also developed ocular pathology and were diagnosed at the time of birth, so they did not received antenatal treatment. A protective effect was found against the ocular involvement in patients whose mother received treatment with spiramycin (OR=0.04;95% CI: 0.00-0.67), p<0.01 (Fisher's Exact Test).

No todo es zika: toxoplasmosis congénita, ¿aún prevalente en Colombia?

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Jorge L Alvarado-Socarras

Full Text Available La toxoplasmosis congénita continúa siendo un problema de salud pública. Aun existiendo guías plenamente divulgadas y conocidas, se observa poca implementación de las mismas y falta de adecuada interpretación de pruebas serológicas en gestantes Esto puede generar falta de captación y tratamiento en embarazadas con primoinfección por Toxoplasma gondii. Reportamos una serie de casos, con compromiso neurológico y sistémico (dificultad respiratoria, hepatoesplenomegalia, enterocolitis, calcificaciones cerebrales, trombocitopenia, corioretinis, ascitis, choque. Si bien el virus de Zika causó epidemia en 2015-2016 en Brasil, Colombia y otros países, toxoplasmosis es un diagnóstico diferencial aún prevalente en estos países, con secuelas graves, discapacidad neurológica y riesgo de daño ocular, incluso tardío. Adicionalmente, existen algunas variedades de cepas de T. gondii con comportamiento más agresivo en Latinoamérica, lo cual empeora la presentación de los casos, incluyendo además mayor riesgo de muerte.

Development of touch down-multiplex PCR for the diagnosis of toxoplasmosis

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V Hallur

2015-01-01

Full Text Available Purpose: The diagnosis of toxoplasmosis is challenging since conventional methods like culture and immunofluorescence are not universally available. Serology, which is used regularly might be negative during early phase of infection and in immunosuppressed patients or may remain positive for a long time. Several molecular tests have been used for the diagnosis of toxoplasmosis, but none of them have an internal control which would inform us regarding the presence of polymerase chain reaction (PCR inhibitors thus, undermining the confidence of a laboratory physician. Materials and Methods: We designed a multiplex PCR containing primers targeting human beta globin gene which would act as internal control and two primers against the B1 gene and 5s gene which aid in sensitive detection of T. gondii. Results: Multiplex PCR had a sensitivity of 83.3% and specificity of 100%. Conclusion: Multiplex PCR may provide a sensitive and specific tool for diagnosis of human toxoplasmosis.

A case of newborn with community acquired pneumonia caused by Cupriavidus pauculus.

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Aydın, Banu; Dilli, Dilek; Zenciroğlu, Ayşegül; Okumuş, Nurullah; Ozkan, Sengül; Tanır, Gönül

2012-01-01

Cupriavidus pauculus is a gram-negative, aerobic, non-spore forming, non-fermentative motile bacillus. The bacillus can be isolated from water, bottled mineral water, and water from ultrafiltration systems in hospital setting. C. pauculus rarely causes human infections, however it may be an infectious agent especially in immunocompromised individuals. In this report, we present the first case of community acquired pneumonia caused by C. pauculus in a previously healthy newborn who was hospitalized in neonatal intensive care unit on postnatal day 16 because of respiratory distress.

Ocular toxoplasmosis: susceptibility in respect to the genes encoding the KIR receptors and their HLA class I ligands

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Ayo, Christiane Maria; Frederico, Fábio Batista; Siqueira, Rubens Camargo; Brandão de Mattos, Cinara de Cássia; Previato, Mariana; Barbosa, Amanda Pires; Murata, Fernando Henrique Antunes; Silveira-Carvalho, Aparecida Perpétuo; de Mattos, Luiz Carlos

2016-01-01

The objective of this study was to investigate the influence of the genes encoding the KIR receptors and their HLA ligands in the susceptibility of ocular toxoplasmosis. A total of 297 patients serologically-diagnosed with toxoplasmosis were selected and stratified according to the presence (n = 148) or absence (n = 149) of ocular scars/lesions due to toxoplasmosis. The group of patients with scars/lesions was further subdivided into two groups according to the type of ocular manifestation observed: primary (n = 120) or recurrent (n = 28). Genotyping was performed by PCR-SSOP. Statistical analyses were conducted using the Chi-square test, and odds ratio with a 95% confidence interval was also calculated to evaluate the risk association. The activating KIR3DS1 gene was associated with increased susceptibility for ocular toxoplasmosis. The activating KIR together with their HLA ligands (KIR3DS1-Bw4-80Ile and KIR2DS1+/C2++ KIR3DS1+/Bw4-80Ile+) were associated with increased susceptibility for ocular toxoplasmosis and its clinical manifestations. KIR-HLA inhibitory pairs -KIR2DL3/2DL3-C1/C1 and KIR2DL3/2DL3-C1- were associated with decreased susceptibility for ocular toxoplasmosis and its clinical forms, while the KIR3DS1−/KIR3DL1+/Bw4-80Ile+ combination was associated as a protective factor against the development of ocular toxoplasmosis and, in particular, against recurrent manifestations. Our data demonstrate that activating and inhibitory KIR genes may influence the development of ocular toxoplasmosis. PMID:27827450

Imaging characteristics of toxoplasmosis encephalitis after bone marrow transplantation: report of two cases and review of the literature

International Nuclear Information System (INIS)

Mueller-Mang, C.; Mang, T.G.; Thurnher, M.M.; Kalhs, P.

2006-01-01

Toxoplasmosis encephalitis is a severe, but often misdiagnosed complication in patients after bone marrow transplantation (BMT). We describe the unique computed tomography (CT) and magnetic resonance (MR) imaging features of cerebral toxoplasmosis in two bone marrow recipients and compare them to the cases in the literature. To our knowledge, this is the first report analyzing the appearance of cerebral toxoplasmosis on diffusion-weighted MR imaging (DWI). (orig.)

Imaging characteristics of toxoplasmosis encephalitis after bone marrow transplantation: report of two cases and review of the literature

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Mueller-Mang, C.; Mang, T.G.; Thurnher, M.M. [University Hospital Vienna, Department of Radiology, Vienna (Austria); Kalhs, P. [University Hospital Vienna, Department of Internal Medicine, Vienna (Austria)

2006-02-15

Toxoplasmosis encephalitis is a severe, but often misdiagnosed complication in patients after bone marrow transplantation (BMT). We describe the unique computed tomography (CT) and magnetic resonance (MR) imaging features of cerebral toxoplasmosis in two bone marrow recipients and compare them to the cases in the literature. To our knowledge, this is the first report analyzing the appearance of cerebral toxoplasmosis on diffusion-weighted MR imaging (DWI). (orig.)

Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care.

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Sousa, Jayra Adrianna da Silva; Corrêa, Rita da Graça Carvalhal Frazão; Aquino, Dorlene Maria Cardoso de; Coutinho, Nair Portela Silva; Silva, Marcos Antonio Custódio Neto da; Nascimento, Maria do Desterro Soares Brandão

2017-06-01

Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women's care during pregnancy, in order to prevent diseases that could compromise the mother and the child's life. This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary - prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women's guidance. The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.

Knowledge and Practices of Toxoplasmosis among Clinical Laboratory Professionals: A Cross-Sectional Study in Durango, Mexico.

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Alvarado-Esquivel, Cosme; Sánchez-Anguiano, Luis Francisco; Berumen-Segovia, Luis Omar; Hernández-Tinoco, Jesús; Rico-Almochantaf, Yazmin Del Rosario; Cisneros-Camacho, Alfredo; Cisneros-Martínez, Jorge Arturo

2017-11-18

Background : The aim of this study was to determine the level of knowledge and practices about toxoplasmosis in a sample of clinical laboratory professionals in Mexico. Methods : 192 clinical laboratory professionals were surveyed. They were asked about (1) Toxoplasma gondii ; (2) clinical manifestations, diagnosis, treatment, and epidemiology of toxoplasmosis; and (3) their practices with respect to toxoplasmosis. Results : The range of animals infected by T. gondii was known by 44.8% of participants. Clinical aspects of toxoplasmosis were known by up to 44.3% of subjects. Correct answers about the interpretation of serological markers of T. gondii infection were provided by up to 32.8% of participants. A minority (32.2%) of participants knew about a high number of false positive results of anti- T. gondii IgM antibody tests. Most participants (90.1%) did not know what the anti- T. gondii IgG avidity test was. Up to 55.7% of participants provided incorrect answers about the interpretation of serology tests for the treatment of pregnant women. Common routes of T. gondii infection were known by toxoplasmosis and a limited practice of laboratory tests among the professionals surveyed.

Significance of chronic toxoplasmosis in epidemiology of road traffic accidents in Russian Federation.

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Stepanova, Ekaterina V; Kondrashin, Anatoly V; Sergiev, Vladimir P; Morozova, Lola F; Turbabina, Natalia A; Maksimova, Maria S; Brazhnikov, Alexey I; Shevchenko, Sergei B; Morozov, Evgeny N

2017-01-01

Studies carried out in Moscow residents have revealed that the prevalence of chronic toxoplasmosis is very close to those in countries of Eastern and Central Europe. Our findings also demonstrated a statistically significant relationship between the rate of traffic accidents and the seroprevalence of chronic toxoplasmosis in drivers who were held responsible for accidents. The latter was 2.37 times higher in drivers who were involved in road accidents compared with control groups. These results suggest that the consequences of chronic toxoplasmosis (particularly a slower reaction time and decreased concentration) might contribute to the peculiarities of the epidemiology of road traffic accidents in the Russian Federation and might interfere with the successful implementation of the Federal Programme named "Increase road traffic safety". Suggestions for how to address overcome this problem are discussed in this paper.

Congenital toxoplasmosis presenting with fetal atrial flutter after maternal ingestion of infected moose meat.

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Colosimo, Sarah M; Montoya, Jose G; Westley, Benjamin P; Jacob, Jack; Isada, Nelson B

2013-09-01

Consumption of undercooked game meat during pregnancy is considered a risk factor for congenital toxoplasmosis, but cases definitively linking ingestion of infected meat to clinical disease are lacking. We report a confirmed case of congenital toxoplasmosis identified because of atrial flutter in the fetus and linked to maternal consumption of Toxoplasma gondii PCR-positive moose meat.

Serological survey of toxoplasmosis, neosporosis and brucellosis ...

African Journals Online (AJOL)

This study sets out to investigate the occurrence of toxoplasmosis, neosporosis and brucellosis among cattle herds in Oyo State, southwest Nigeria. Materials and Methods: A cross-sectional survey to screen for antibodies to Toxoplasma gondii, Neospora caninum and Brucella abortus was conducted among 174 cattle in 17 ...

Disease patterns and causes of death of hospitalized HIV-positive adults in West Africa

DEFF Research Database (Denmark)

Lewden, Charlotte; Drabo, Youssoufou J; Zannou, Djimon M

2014-01-01

%) and cerebral toxoplasmosis (10%). Overall, 315 (38%) patients died during hospitalization and the underlying cause of death was AIDS (63%), non-AIDS-defining infections (26%), other diseases (7%) and non-specific illness or unknown cause (4%). Among them, the most frequent fatal diseases were: tuberculosis (36......%), cerebral toxoplasmosis (10%), cryptococcosis (9%) and sepsis (7%). Older age, clinical WHO stage 3 and 4, low CD4 count, and AIDS-defining infectious diagnoses were associated with hospital fatality. CONCLUSIONS: AIDS-defining conditions, primarily tuberculosis, and bacterial infections were the most...

Azithromycin prophylaxis and treatment of murine toxoplasmosis.

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Tabbara, Khalid F; Hammouda, Ehab; Tawfik, Abdulkader; Al-Omar, Othman M; Abu El-Asrar, Ahmed M

2005-03-01

To evaluate the azithromycin effects alone and in combination with other agents in the prophylaxis and treatment of murine toxoplasmosis. A total of 280 BALB/c mice were included, and 2 x 103 Toxoplasma organisms of the RH strain Toxoplasma gondii strain ATCC50174 were given intraperitoneally to each mouse. In experiment one, 40 animals were given azithromycin 200 milligram/kilogram/daily for 3 days starting the day of inoculation, 40 mice were control. In experiment 2, the treatment was started 48 hours after inoculation and given daily for 3 days: one group received azithromycin 200 milligram/kilogram/day, the second group received pyrimethamine 25 milligram/kilogram/day, and the sulfadiazine 100 milligram/kilogram/day. The third group was control. In experiment 3, 7 groups of animals received one of the following (1) none, (2) azithromycin 200 milligram/kilogram/day, (3) pyrimethamine 25 milligram/kilogram/day and sulfadiazine 100 milligram/kilogram/day, (4) azithromycin and sulfadiazine, (5) azithromycin and pyrimethamine, (6) azithromycin with sulfadiazine and pyrimethamine, (7) sulfadiazine alone. Treatment was initiated 72 hours after inoculation for 3 days. The study was conducted at the Animal Care Facility of King Saud University, Riyadh, Kingdom of Saudi Arabia. Animals that received azithromycin simultaneously with inoculation survived, and all control animals died. All animals died in groups receiving single drug therapy. Animals treated with azithromycin and sulfadiazine showed a survival rate of 40%, sulfadiazine and pyrimethamine 40%, or azithromycin with sulfadiazine and pyrimethamine 95% (p<0.0001). Azithromycin alone was found to be effective in the prophylaxis of murine toxoplasmosis. Combination therapy was effective in the treatment of murine toxoplasmosis.

Toxoplasmosis: Seroprevalence in pregnant women, and serological and molecular screening in neonatal umbilical cord blood.

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Shieh, Mahshad; Didehdar, Mojtaba; Hajihossein, Reza; Ahmadi, Farzam; Eslamirad, Zahra

2017-10-01

Toxoplasmosis is a common zoonotic disease that can also be transmitted from the mother to the embryo, with the risk of congenital infection varying around the world. The aim of this study was to screen pregnant women and their neonates for toxoplasmosis by serologic and molecular methods and assess the impact of risk factors associated with toxoplasmosis on the rate of congenital infection. This study was conducted at a regional maternity hospital in Arak, the capital of the Markazi Province in Iran, during a period of six months. All selected pregnant women (n=261) and the corresponding cord blood samples were serologically screened for toxoplasmosis, with seropositive samples also undergoing molecular testing. Demographic data, as well as information related to the risk factors associated with the transmission of the disease, were collected from mothers and their neonates. The detection of anti-Toxoplasma antibodies and the extraction of DNA from blood samples were conducted using commercial kits. Results showed that the sera of 87 maternal blood samples (33.3%) and 40 cord blood samples (15.3%) were positive for anti-Toxoplasma antibodies (IgG and/or IgM). Molecular screening of the seropositive samples only identified one positive cord blood sample. In other words, the diagnosis of congenital toxoplasmosis was definitive in only one neonate. There was no significant association between the risk of parasite transmission and neonatal seropositivity (p >0.05). Therefore, the results showed that the prevalence of congenital toxoplasmosis in the studied area was consistent with the global rate and suggest that the implementation of newborn screening and follow-up testing could help reduce the disease risk. Copyright © 2017 Elsevier B.V. All rights reserved.

Contribution of computerized tomography to diagnosis of congenital toxoplasmosis

International Nuclear Information System (INIS)

Kouba, K.; Kalvach, P.; Nevarilova, A.; Stankova, M.

1986-01-01

Computerized tomography (CT) of the brain in 20 patients (age 6 to 20 years) with the ocular form of toxoplasmosis and various damage of the CNS revealed that in 8 patients intracranial calcifications were present while no calcifications were found on the X-ray of the skull. On the CT also other pathological findings were detected in the brain apart from calcifications. (Similarly as in 25% of the AIDS syndrome where affections of the CNS are not yet known.) Based on the authors'experience and data from abroad, CT examination of the brain can be recommended as very useful for the confirmation of the diagnosis of congenital toxoplasmosis also with regard to the prognosis of further psychomotoric development of the child. (author). 2 tabs., 7 refs

CLINICO-MICROBIOLOGICAL STUDY OF TOXOPLASMOSIS IN PREGNANT FEMALES WITH BAD OBSTETRIC HISTORY (BOH

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Neha Singh

2017-09-01

Full Text Available BACKGROUND Context- Toxoplasmosis is an infection caused by a microscopic parasite called Toxoplasma gondii. Although, the infection generally causes a mild symptomless illness in people with healthy immune systems, it is of risk during pregnancy as it can infect the growing foetus in utero. The aim of the study is to assess the seroprevalence of IgG and IgM antibodies for toxoplasmosis in women with normal pregnancy, pregnant women with one abortion and pregnant women with two or more abortions (BOH. The seropositivity was analysed according to number of abortions, age, parity and trimester of pregnancy. MATERIALS AND METHODS Serum samples were collected from pregnant women attending antenatal clinic with demographic data. Patients were divided into three groups- Normal pregnant women without any history of abortion (N, pregnant patients with one abortion (A1 and those with two or more abortions (A2 that is those with a Bad Obstetric History (BOH. 83 serum samples were subjected for determination of toxoplasma IgM antibodies and 81 for toxoplasma IgG antibodies. The study was carried out over a period of two years from November 2012 to October 2014. Settings and Design- Experimental and analytical study. RESULTS Toxoplasma IgM prevalence was 1.2% and that of IgG was 27.16%. The distribution showed increase of IgG and IgM with increase in the number of abortions. In normal group patients (N, IgG was mostly positive for patients with gestational age 2nd trimester (13-28 weeks. The distribution also showed that in this group IgG was positive for those in the age group of 20- 25 years. In group, A1 patients IgG was equally positive for those with gestational age 2nd trimester (13-28 weeks and 3rd trimester (29-40 weeks. In this group, IgG was mostly positive for those in the age group of 20-25 years and 26-30 years, respectively. The distribution for group A2 patients showed an increase of IgG antibodies for those with gestational age 1st trimester

Toxoplasmosis seroprevalence in relation to knowledge and practice among pregnant women in Dhahran, Saudi Arabia.

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Elsafi, Salah H; Al-Mutairi, Wasaef F; Al-Jubran, Khalid M; Abu Hassan, Mohamed M; Al Zahrani, Eidan M

2015-01-01

The epidemiological importance of the different routes of Toxoplasma gondii transmission is not known and depends largely on population behaviour and knowledge. This study was conducted to assess toxoplasmosis seropositivity and the related knowledge and preventive practices that are necessary for the prevention of the disease among pregnant women. All pregnant women attending antenatal clinic were tested for T. gondii immunoglobulins followed by a survey questionnaire that tested their knowledge and preventive practice. Statistical comparisons were made between the seropositive and negative ones. We determined a low to moderate seroprevalence of toxoplasmosis among pregnant women in Dhahran, Saudi Arabia as compared to many other parts of the world. The overall positivity rates of IgG and IgM against T. gondii among 400 pregnant women were 28.5 and 3%, respectively. 75.5% of the participants had never heard about toxoplasmosis and the associated risk factors. Lack of knowledge was associated with the higher risk of infection (OR = 4.04, p restaurants was reported for the first time to be related to a higher risk of infection (OR = 2.69, p < 0.001). Several possible risk factors were suggested through odds ratios calculation and overall knowledge of toxoplasmosis by pregnant women was poor. It is therefore vital to provide a formal education about toxoplasmosis risk factors to women of childbearing age.

Seroprevalence of toxoplasma-specific antibodies in patients suspected to have active toxoplasmosis: A cross-sectional survey

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Abbas Ali Eskandarian

2014-01-01

Full Text Available Background: The aim of this study was to investigate the presence and distribution of anti-toxoplasma-specific IgM and IgG tantibodies in patients suspected to have toxoplasmosis and investigate for any association between IgM and IgG antibodies and some toxoplasmosis risk factors as well. Materials and Methods: In a comparative cross-sectional study, 70 patients suspected to had active toxoplasmosis and 30 control volunteers, who gave informed consent, entered the study. In each group, patient age, sex, signs of appearance, education level, residency status (urban / rural, occupation, frequency of toxoplasma-specific IgG and IgM antibodies, abortion history, and some risk factors (Direct cat exposure, Occupational exposure to raw meat, and Raw vegetable consumption were recorded. The enzyme-linked immunosorbent assay (ELISA kits (EUROIMMUN®, United Kingdom were used for the evaluation of anti-toxoplasma IgG and IgM antibodies according to the manufacturer›s instructions. All analyses were done using SPSS-20. Results: The frequency of toxoplasma-specific IgG and IgM antibodies like: Direct cat exposures, Occupational exposure to raw meat, and Raw vegetable consumption were not statistically significant between the two groups (P > 0.05. The history of previous abortions in women in the toxoplasmosis-suspected group was significantly higher than that in the controls (31.4% versus 6.7%; P = 0.009. Conclusion: The frequency of specific IgM and IgG antibodies in toxoplasmosis suspected in the toxoplasmosis and control groups was not statistically significant.

Advances in the causes and management of community acquired pneumonia in adults.

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Wunderink, Richard G; Waterer, Grant

2017-07-10

Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia. Optimal treatment remains a matter for debate, especially in very sick patients, including the role of combination antibiotic therapy and corticosteroids. Pneumonia care bundles are being defined to improve outcomes. Increased recognition of both acute and long term cardiac complications is shifting our concept of pneumonia from an acute lung disease to a multisystem problem with adverse chronic health consequences. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

MRI of intracranial toxoplasmosis after bone marrow transplantation

International Nuclear Information System (INIS)

Dietrich, U.; Doerfler, A.; Forsting, M.; Maschke, M.; Prumbaum, M.

2000-01-01

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. (orig.)

Epidural anesthesia as a cause of acquired spinal subarachnoid cysts

International Nuclear Information System (INIS)

Sklar, E.M.L.; Quencer, R.M.; Green, B.A.; Post, M.J.D.; Montalvo, B.M.

1988-01-01

Six patients with acquired spinal subarachnoid cysts secondary to epidural anesthesia were evaluated with MR imaging (seven patients) and intraoperative US (three patients). The cysts were located in the lower cervical and thoracic spine. Adhesions and irregularity of the cord surface were frequently noted. Associated intramedullary lesions, including intramedullary cysts and myelomalacia, were seen in two of the patients. Arachnoiditis was unsuspected clinically in three patients, and MR imaging proved to be the diagnostic examination that first suggested the cause of the patients symptoms. The underlying mechanism for the formation of these cysts is a chemically induced arachnoiditis

Role of advanced magnetic resonance imaging techniques in diagnosis of cerebral toxoplasmosis in immunocompromised patients: A case report

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Inderpreet Singh

2014-01-01

Full Text Available Cerebral toxoplasmosis commonly affects patients with advanced HIV infection. Toxoplasmosis can be severe and debilitating in patients with Central Nervous System (CNS involvement and the condition may be fatal in patients if not suspected and treated early and adequately. Hence, imaging plays an important role in diagnosis and following during treatment in cases of suspected toxoplasmosis. We report a case of a 51-years-old man who was a known sero-positive since 2 years and presented with altered sensorium. Magnetic Resonance Imaging (MRI scan of the brain showed multiple heterogeneously enhancing lesions in bilateral cerebral as well as cerebellar hemispheres and some of them showed "eccentric target sign." MR spectroscopy showed features of reduced NAA, mildly increased choline, and lipid lactate peak. MR perfusion study showed reduced perfusion favoring diagnosis of cerebellar toxoplasmosis. Patient was started on a combination of pyrimethamine plus sulfadiazine for toxoplasmosis. Follow up MRI after 20 days and 45 days from start of treatment showed significant resolution of the lesions supporting our radiological diagnosis.

Seroprevalence of toxoplasmosis in Fortaleza, Ceará, Brazil

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REY Luís C.

1999-01-01

Full Text Available A serological survey of Toxoplasma gondii infection in population groups in Fortaleza, Brazil, was conducted, in order to identify seroprevalence rates according to age and risk factors associated with acquired infection. A Toxoplasma IgG-antibody enzyme immunoassay (Sanofi Pasteur Diagnostics, Marnes la Coquette, France was employed to assess the immunity. Public day-care centers and schools were randomly selected, while three large antenatal clinics and maternity units were choosen by its importance. Population groups and results of 997 blood tests were: 227 children (mean age 3.8 years, 22.8% seropositives; 584 students (mean 11.4 years, 58.4%, and pregnant and postpartum women (mean 24 years, 71.5% seropositives (p < 0.001. Of 256 participants reporting close contact with cats, 59.8% were seropositive, in contrast with 51% seropositives without contact (relative risk 1.17; 95% confidence interval 1.04-1.33; p = 0.01. Having three or more siblings at home was related to higher seroprevalence in children and students (relative risk 1.39; 95% confidence interval 1.21-1.60; p < 0.01. In conclusion, toxoplasmosis seroprevalence showed a rapid increase during the first ten years of life, in association with close contact with cats and larger households, probably related to inappropriate hygiene and child-care practices.

Molecular diagnosis of toxoplasmosis in immunocompromised patients: a 3-year multicenter retrospective study.

Science.gov (United States)

Robert-Gangneux, Florence; Sterkers, Yvon; Yera, Hélène; Accoceberry, Isabelle; Menotti, Jean; Cassaing, Sophie; Brenier-Pinchart, Marie-Pierre; Hennequin, Christophe; Delhaes, Laurence; Bonhomme, Julie; Villena, Isabelle; Scherer, Emeline; Dalle, Frédéric; Touafek, Feriel; Filisetti, Denis; Varlet-Marie, Emmanuelle; Pelloux, Hervé; Bastien, Patrick

2015-05-01

Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Rare acquired hemostatic disorders as a cause of prolonged bleeding – presentation of two case reports

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Polona Novak

2011-10-01

Full Text Available BACKGROUNDPatient’s anamnesis is of primary importance in determining hemostatic disorders. Based on anamnestic data, a clinician may decide for further laboratory tests. We must consider an acquired bleeding disorder in a patient with unusual, unexpected and prolonged bleeding episodes. In this article we will describe two rare acquired hemostatic disordes.TWO CASE REPORTSOur first patient had prolonged bleeding after a pacemaker implantation. We diagnosed him with acquired von Willebrand syndrome. Further on, the patient required a planned surgical procedure. In our second case we describe a patient with unusual and excessive skin bruising and prolonged bleeding after teeth extractions. He was diagnosed with acquired hemophilia.CONCLUSIONIn the assessment of a patient with a potential acquired bleeding disorder we must first rule out the most common causes, such as iatrogenic ones. But, because of high morbidity and mortality rates, we must also be aware of some rare acquired bleeding disorders. In case of uncertainty, we should consult with a hematologist.

Causes of non-adherence to therapeutic guidelines in severe community-acquired pneumonia

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Gattarello, Simone; Ramírez, Sergio; Almarales, José Rafael; Borgatta, Bárbara; Lagunes, Leonel; Encina, Belén; Rello, Jordi

2015-01-01

Objective To assess the adherence to Infectious Disease Society of America/American Thoracic Society guidelines and the causes of lack of adherence during empirical antibiotic prescription in severe pneumonia in Latin America. Methods A clinical questionnaire was submitted to 36 physicians from Latin America; they were asked to indicate the empirical treatment in two fictitious cases of severe respiratory infection: community-acquired pneumonia and nosocomial pneumonia. Results In the case of communityacquired pneumonia, 11 prescriptions of 36 (30.6%) were compliant with international guidelines. The causes for non-compliant treatment were monotherapy (16.0%), the unnecessary prescription of broad-spectrum antibiotics (40.0%) and the use of non-recommended antibiotics (44.0%). In the case of nosocomial pneumonia, the rate of adherence to the Infectious Disease Society of America/American Thoracic Society guidelines was 2.8% (1 patient of 36). The reasons for lack of compliance were monotherapy (14.3%) and a lack of dual antibiotic coverage against Pseudomonas aeruginosa (85.7%). If monotherapy with an antipseudomonal antibiotic was considered adequate, the antibiotic treatment would be adequate in 100% of the total prescriptions. Conclusion The compliance rate with the Infectious Disease Society of America/American Thoracic Society guidelines in the community-acquired pneumonia scenario was 30.6%; the most frequent cause of lack of compliance was the indication of monotherapy. In the case of nosocomial pneumonia, the compliance rate with the guidelines was 2.8%, and the most important cause of non-adherence was lack of combined antipseudomonal therapy. If the use of monotherapy with an antipseudomonal antibiotic was considered the correct option, the treatment would be adequate in 100% of the prescriptions. PMID:25909312

The national neonatal screening programme for congenital toxoplasmosis in Denmark: results from the initial four years, 1999-2002

DEFF Research Database (Denmark)

Schmidt, Dorte Remmer; Høgh, Birthe; Andersen, O

2006-01-01

AIMS: To describe the outcome of four years' nationwide neonatal screening for congenital toxoplasmosis in liveborn newborns. METHODS: Congenital toxoplasmosis was diagnosed if specific Toxoplasma gondii IgM antibodies were detected in eluate from the PKU Guthrie filter paper card from a child....... Infants diagnosed with congenital toxoplasmosis were examined for intracranial and retinal lesions and treated for three months with sulphadiazine, pyrimethamine, and folinic acid continuously. RESULTS: Eluates from PKU-cards from 262 912 newborns were analysed. The birth prevalence of congenital...... toxoplasma infection was 2.1 per 10 000 liveborns. Congenital toxoplasmosis was suspected in 96 infants and confirmed in 55. Forty seven children were examined for intracranial and retinal lesions soon after birth; 12 had clinical signs at this first examination. Of these, 5 had intracranial calcifications...

Cholestasis caused by panhypopituitarism and acquired cytomegalovirus infection in a 2-month-old male infant

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Chan, U; Chan, Wai-Tao; Ting, Wei-Hsin; Ho, Che-Sheng; Liu, Hsi-Che; Lee, Hung-Chang

2017-01-01

Abstract Rationale: Septo-optic dysplasia (SOD) is a rare congenital disorder that may cause jaundice in infants. However, it is usually prone to neglect and misdiagnosis in infants with cholestasis because endocrine disorder such as panhypopituitarism is rare in the cause of infantile cholestasis. We report a case of SOD concurrent with acquired cytomegalovirus (CMV) infection, who presented with prolonged jaundice as the first clinical sign. Patient concerns: The patient was a 2-month-old male infant who presented with cholestasis, combined with fever and panhypopituitarism. Diagnoses: He was diagnosed with SOD and acquired CMV infection. Interventions: He was treated with hormone replacement therapy and ganciclovir. Outcomes: After correction of the pituitary hormone deficiency and ganciclovir treatment, significant improvements of cholestasis, retinal lesions, and growth rate were seen in our patient. Lessons: Although an endocrine disorder such as panhypopituitarism is rare in the cause of neonatal or infantile cholestasis, we must keep this reason in mind. PMID:28445302

Congenital toxoplasmosis: systematic review of evidence of efficacy of treatment in pregnancy

Science.gov (United States)

Wallon, Martine; Liou, Christiane; Garner, Paul; Peyron, François

1999-01-01

Objective To summarise the evidence that treating toxoplasmosis in pregnancy reduces the risk of congenital toxoplasma infection and improves infant outcomes. Design Systematic review of studies comparing at least two concurrent groups of pregnant women with proved or likely acute toxoplasma infection in which treatments were compared with no treatment and outcomes in the children were reported. Subjects Studies were identified from Medline (1966-97), Pascal (1990-7), Embase (1993-7), and Biological abstracts (1993-5) plus contact with experts in the field, including the European Research Network on Congenital Toxoplasmosis. Main outcome measure Proportion of infected children at 1 year born to infected pregnant women who were or were not treated. Results Out of 2591 papers identified, nine met the inclusion criteria. There were no randomised comparisons, and control groups were generally not directly comparable with the treatment groups. Congenital infection was common in treated groups. five studies showed that treatment was effective and four that it was not. Conclusion It is unclear whether antenatal treatment in women with presumed toxoplasmosis reduces congenital transmission of Toxoplasma gondii. Screening is expensive, so the effects of treatment and impact of screening programmes need to be evaluated. In countries where screening or treatment is not routine, these technologies should not be introduced outside carefully controlled trials. Key messagesPregnant women in France and Austria are routinely screened for toxoplasmosis, and women negative for antibodies are followed up at regular intervalsThe value of antenatal toxoplasmosis screening programmes depends on safe treatments that reduce the risk of congenital diseaseThis systematic review found no good comparative data measuring the potential harms and benefits of antiparasitic drugs used for presumed antenatal toxoplasma infectionMost control groups were not comparable, and incidence of congenital

Toxoplasmosis can be a sexually transmitted infection with serious clinical consequences. Not all routes of infection are created equal.

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Flegr, J; Klapilová, K; Kaňková, S

2014-09-01

Toxoplasma gondii infects about 30% of the human population. Common sources of infection are oocysts in cat faeces contaminating drinking water or unwashed vegetables, undercooked meat containing tissue cysts, and organ transplants from infected donors containing tissue cysts. However, very often, it is not possible to identify any potential source of infection in mothers of children with congenital toxoplasmosis. Here we present a hypothesis suggesting that toxoplasmosis is transmitted from infected men to noninfected women during unprotected sexual intercourse, which can result in the most serious form of disease, congenital toxoplasmosis. Arguments for the hypothesis: (1) Toxoplasma tachyzoites are present in the seminal fluid and tissue of the testes of various animals including humans. In some species infection of females by artificial insemination with semen from infected males has been observed. (2) Up to two thirds of Toxoplasma infections in pregnant women cannot be explained by the known risk factors. (3) Prevalence of toxoplasmosis in women in child-bearing age covaries with the incidence of sexually transmitted diseases in particular countries. (4) In some countries, an increased incidence of toxoplasmosis has been reported in women (but not men) aged 25-35 years. This second peak of infection could be associated with women having regular unprotected sex after marriage. (5) Toxoplasmosis triggers schizophrenia in predisposed subjects. Onset of schizophrenia is about 2-3 years earlier in men than in women. However, this difference in the onset can be found only between Toxoplasma-infected patients. The increased onset of schizophrenia in infected women could be associated with the already mentioned second peak of toxoplasmosis incidence. (6) The prevalence of toxoplasmosis decreases in developed countries in last 20 years. This trend could be a result of decrease in promiscuity and increase in safe sex practices, both associated with the AIDS pandemics

Prevalence of leptospirosis and toxoplasmosis: A study of rodents ...

African Journals Online (AJOL)

prevalence of toxoplasmosis in child-bearing women in rural Sudan is even higher ranging ... crops. Animal trapping. Live rodents and shrews were captured in cultivated ..... P., Hodný, Z. & Vondrová, M. (2011) Fatal attraction phenomenon in.

Severe community-acquired pneumonia caused by Mycoplasma pneumoniae in young female patient

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Milačić Nena

2015-07-01

Full Text Available Mycoplasma pneumonia is common agent causing community acquired pneumonia in younger population. However, the course of illness is usually benign and is rarely associated with pulmonary complications. We report a 27 years old female patient with unilateral pneumonia followed by pleural effusion and adhesions on the same side. This potential source of infection should be considered in young patients where resolution of symptoms from pneumonia is delayed.

Toxoplasma gondii infection in Kyrgyzstan: seroprevalence, risk factor analysis, and estimate of congenital and AIDS-related toxoplasmosis.

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Gulnara Minbaeva

Full Text Available BACKGROUND: HIV-prevalence, as well as incidence of zoonotic parasitic diseases like cystic echinococcosis, has increased in the Kyrgyz Republic due to fundamental socio-economic changes after the breakdown of the Soviet Union. The possible impact on morbidity and mortality caused by Toxoplasma gondii infection in congenital toxoplasmosis or as an opportunistic infection in the emerging AIDS pandemic has not been reported from Kyrgyzstan. METHODOLOGY/PRINCIPAL FINDINGS: We screened 1,061 rural and 899 urban people to determine the seroprevalence of T. gondii infection in 2 representative but epidemiologically distinct populations in Kyrgyzstan. The rural population was from a typical agricultural district where sheep husbandry is a major occupation. The urban population was selected in collaboration with several diagnostic laboratories in Bishkek, the largest city in Kyrgyzstan. We designed a questionnaire that was used on all rural subjects so a risk-factor analysis could be undertaken. The samples from the urban population were anonymous and only data with regard to age and gender was available. Estimates of putative cases of congenital and AIDS-related toxoplasmosis in the whole country were made from the results of the serology. Specific antibodies (IgG against Triton X-100 extracted antigens of T. gondii tachyzoites from in vitro cultures were determined by ELISA. Overall seroprevalence of infection with T. gondii in people living in rural vs. urban areas was 6.2% (95%CI: 4.8-7.8 (adjusted seroprevalence based on census figures 5.1%, 95% CI 3.9-6.5, and 19.0% (95%CI: 16.5-21.7 (adjusted 16.4%, 95% CI 14.1-19.3, respectively, without significant gender-specific differences. The seroprevalence increased with age. Independently low social status increased the risk of Toxoplasma seropositivity while increasing numbers of sheep owned decreased the risk of seropositivity. Water supply, consumption of unpasteurized milk products or undercooked

Prevalence of malaria, typhoid, toxoplasmosis and rubella among febrile children in Cameroon.

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Achonduh-Atijegbe, Olivia A; Mfuh, Kenji O; Mbange, Aristid H E; Chedjou, Jean P; Taylor, Diane W; Nerurkar, Vivek R; Mbacham, Wilfred F; Leke, Rose

2016-11-08

44 %. There was a significant association between ITN non-usage and malaria (p = 0. 029) as well as drinking water and presence of typhoid (p = 0.047). No association was observed between type of housing and malaria, or toxoplasmosis and raising cats. Though malaria still remains the major cause of fever in children, using RDTs for other treatable febrile illnesses like typhoid and toxoplasmosis could facilitate the optimal management of febrile illnesses in children especially when these occur as co-infections with malaria.

An outbreak of toxoplasmosis in an aviary collection of Nicobar pigeons (Caloenas nicobaria : clinical communication

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R.D. Last

2008-05-01

Full Text Available Three out of 10 Nicobar pigeons (Caloenas nicobaria in an aviary collection in South Africa were found dead with no presenting clinical symptoms. Histological examination of formalin-fixed tissues from all these birds revealed necrotic foci in various visceral organs (liver, spleen, heart, kidney and lungs, plus diffuse pulmonary congestion and oedema with vasculitis. Numerous protozoal tachyzoites were present in all organs and there was strong positive immunohistochemical (IHC labelling of these organisms for Toxoplasma gondii. Pathology was consistent with acute systemic toxoplasmosis as a consequence of oocyst ingestion. Feral cats were known to be a problem at the facility. Clinical toxoplasmosis is rarely reported in pigeons and this is believed to be the 1st report of toxoplasmosis in Nicobar pigeons.

An assessment of Toxoplasmosis antibodies seropositivity in children suffering Autism

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Shahla Afsharpaiman

2014-05-01

Conclusion: There was no statistically significant difference in comparing positive se-rology of toxoplasmosis, between the two groups. However, to obtain a perfect result, a larger sample size are required.

Community-Acquired Pneumonia and Empyema Caused by Citrobacter koseri in an Immunocompetent Patient

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Miguel Angel Ariza-Prota

2015-01-01

Full Text Available Citrobacter species, belonging to the family Enterobacteriaceae, are environmental organisms commonly found in soil, water, and the intestinal tracts of animals and humans. Citrobacter koseri is known to be an uncommon but serious cause of both sporadic and epidemic septicemia and meningitis in neonates and young infants. Most cases reported have occurred in immunocompromised hosts. The infections caused by Citrobacter are difficult to treat with usual broad spectrum antibiotics owing to rapid generation of mutants and have been associated with high death rates in the past. We believe this is the first case described in the literature of a community-acquired pneumonia and empyema caused by Citrobacter koseri in an immunocompetent adult patient.

Death rates for acquired hypothyroidism and thyrotoxicosis in English populations (1979-2010): comparison of underlying cause and all certified causes.

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Goldacre, M J; Duncan, M E

2013-03-01

Overt hypothyroidism and thyrotoxicosis have widespread systemic effects and are associated with increased mortality. Most death certificates that include them do not have the thyroid disease coded as the underlying cause of death. To describe regional (1979-2010) and national (1995-2010) trends in mortality rates for acquired hypothyroidism and thyrotoxicosis, analysing all certified causes of death (termed 'mentions') and not just the underlying cause. Analysis of death registration data. Analysis of data for the Oxford region (mentions available from 1979) and English national data (mentions available from 1995). The data were grouped in periods defined by different national rules for selecting the underlying cause of death (1979-83, 1984-92, 1993-2000 and 2001-10) and were also analysed as single calendar years. Mentions mortality for acquired hypothyroidism in the Oxford region declined significantly from 1979 to 2010: the average annual percentage change (AAPC) was -2.6% (95% confidence intervals -3.5, -1.8). Most of the decrease occurred during the 1980s. The AAPC in rates for later years in England (1995-2010) was non-significant at 0.2% (-0.7, 1.0). Mortality rates for thyrotoxicosis decreased significantly: the AAPC was -2.8% (-4.1, -1.5) in the Oxford region and -3.8% (-4.7, -3.0) in England. In England, between 2001 and 2010, hypothyroidism or thyrotoxicosis was coded as the underlying cause of death on, respectively, 17 and 24% of death certificates that included them. Mortality rates for hypothyroidism and thyrotoxicosis have fallen substantially. The fall is probably wholly or mainly a result of improved care.

Epstein-Barr virus-associated primary central nervous system lymphoma in a child with the acquired immunodeficiency syndrome. A case report and review of the literature.

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Rodriguez, M M; Delgado, P I; Petito, C K

1997-12-01

A 34-month-old black boy who had contracted acquired immunodeficiency syndrome from his mother presented with fever, vomiting, and cough. He was cachectic, hypertonic, and developmentally delayed. A brain computed tomography scan revealed masses in the left frontal horn, subependymal, and periventricular regions; secondary edema; and hydrocephalus. The differential diagnosis was cerebral lymphoma versus toxoplasmosis. The patient had disseminated Mycobacterium avium-intracellulare infection, lymphoid interstitial pneumonitis, as well as Pseudomonas and Klebsiella pneumonia. He died of respiratory insufficiency 53 days after admission. The autopsy confirmed a primary cerebral B-cell lymphoma, large cell type, which was positive for Epstein-Barr virus, latent phase, by in situ hybridization. Primary central nervous system lymphomas are rare in children, in contrast to adults. To our knowledge, only five well-documented cases of primary cerebral lymphomas in infants and children with acquired immunodeficiency syndrome have been reported previously. The current study shows that these childhood lymphomas are associated with and presumably caused by Epstein-Barr virus and thus have a pathogenesis similar to that of primary central nervous system lymphomas in adults.

Toxoplasmosis-related risk factors in pregnant women in the North Khorasan province, Iran

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Mohammad Ali Mohaghegh

2016-08-01

Full Text Available Congenital toxoplasmosis is a disease with sever clinical manifestations in newborns so screening of pregnant women is crucial. This study was aimed at evaluating the latest status of toxoplasmosis in pregnant women and its respective risk factors in the northeast of Iran. This survey was conducted between 2013 and 2015 on 350 pregnant women. Blood samples were taken from the participants and their serums were separated. Anti-Toxoplasma IgG and IgM were assessed in the serum samples using ELISA method. Moreover, a questionnaire about toxoplasmosisrelated risk factors and other information was completed by each participant. Of the 350 pregnant women studied, 110 (31.42% were positive for IgG and 12 (3.42% for IgM. The IgM-positive subjects were also positive for IgG. Age of pregnancy, residence area, contact with cat, degree of meat cooking, unwashed raw vegetable or fruit consumption, raw milk consumption, and history of miscarriage were toxoplasmosis-related risk factors considered in this study, the results showed that all these factors were statistically significant in IgG-positive subjects. In IgMpositive subjects, contact with cat, degree of meat cooking, unwashed raw vegetables, fruits consumption, and history of miscarriage were among the more important risk factors. The new cases of toxoplasmosis are being occurring in the pregnant women in the region under the study and therefore these pregnancies are uncertain.

A rare case of pulmonary toxoplasmosis in a patient with undifferentiated inflammatory arthritis on chronic methotrexate and corticosteroid therapy.

Science.gov (United States)

Abdulkareem, Abdullateef; D'Souza, Ryan Steven; Patel, Nitin; Donato, Anthony A

2017-08-23

Pulmonary toxoplasmosis is a serious pulmonary condition caused by the protozoan Toxoplasma gondii It typically affects immunocompromised patients presenting acutely with cough, fever, myalgias, arthralgias and lymphadenopathy, and chronically with persistent cough and dyspnoea. Because of its protean features, it can mimic many more common lung conditions in the immunocompromised patient, including atypical pneumonia, Pneumocystis pneumonia and interstitial lung disease. In this article, we present the case of a 55-year-old woman who presented to our hospital with persistent dyspnoea and cough, initially suspected to have an arthritis-related interstitial lung disease. She received a final diagnosis of pulmonary toxoplasmosis after lung biopsy demonstrated Toxoplasma cysts, later confirmed by serology. Treatment with trimethoprim-sulfamethoxazole resulted in significant improvement of her respiratory symptoms after 3 months. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Intraocular Inflammation Associated with Ocular Toxoplasmosis : Relationships at Initial Examination

NARCIS (Netherlands)

Dodds, Emilio M.; Holland, Gary N.; Stanford, Miles R.; Yu, Fei; Siu, Willie O.; Shah, Kayur H.; Loon, Ninette Ten Dam-Van; Muccioli, Cristina; Hovakimyan, Anna; Barisani-Asenbauer, Talin

2008-01-01

PURPOSE: To describe characteristics of intraocular inflammation in eyes with active ocular toxoplasmosis and to identify relationships between signs of inflammation, complications (including elevated intraocular pressure [IOP]), other disease features, and host characteristics. DESIGN: Multicenter,

Molecular diagnosis of toxoplasmosis: value of the buffy coat for the detection of circulating Toxoplasma gondii.

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Brenier-Pinchart, Marie-Pierre; Capderou, Elodie; Bertini, Rose-Laurence; Bailly, Sébastien; Fricker-Hidalgo, Hélène; Varlet-Marie, Emmanuelle; Murat, Jean-Benjamin; Sterkers, Yvon; Touafek, Fériel; Bastien, Patrick; Pelloux, Hervé

2015-08-01

Early detection of Toxoplasma tachyzoites circulating in blood using PCR is recommended for immunosuppressed patients at high risk for disseminated toxoplasmosis. Using a toxoplasmosis mouse model, we show that the sensitivity of detection is higher using buffy coat isolated from a large blood volume than using whole blood for this molecular monitoring. Copyright © 2015 Elsevier Inc. All rights reserved.

Interaction between Helicobacter pylori and latent toxoplasmosis and demographic variables on cognitive function in young to middle-aged adults.

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Gale, Shawn D; Erickson, Lance D; Brown, Bruce L; Hedges, Dawson W

2015-01-01

Helicobacter pylori and latent toxoplasmosis are widespread diseases that have been associated with cognitive deficits and Alzheimer's disease. We sought to determine whether interactions between Helicobacter pylori and latent toxoplasmosis, age, race-ethnicity, educational attainment, economic status, and general health predict cognitive function in young and middle-aged adults. To do so, we used multivariable regression and multivariate models to analyze data obtained from the United States' National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention, which can be weighted to represent the US population. In this sample, we found that 31.6 percent of women and 36.2 percent of men of the overall sample had IgG Antibodies against Helicobacter pylori, although the seroprevalence of Helicobacter pylori varied with sociodemographic variables. There were no main effects for Helicobacter pylori or latent toxoplasmosis for any of the cognitive measures in models adjusting for age, sex, race-ethnicity, educational attainment, economic standing, and self-rated health predicting cognitive function. However, interactions between Helicobacter pylori and race-ethnicity, educational attainment, latent toxoplasmosis in the fully adjusted models predicted cognitive function. People seropositive for both Helicobacter pylori and latent toxoplasmosis - both of which appear to be common in the general population - appear to be more susceptible to cognitive deficits than are people seropositive for either Helicobacter pylori and or latent toxoplasmosis alone, suggesting a synergistic effect between these two infectious diseases on cognition in young to middle-aged adults.

Interaction between Helicobacter pylori and latent toxoplasmosis and demographic variables on cognitive function in young to middle-aged adults.

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Shawn D Gale

Full Text Available Helicobacter pylori and latent toxoplasmosis are widespread diseases that have been associated with cognitive deficits and Alzheimer's disease. We sought to determine whether interactions between Helicobacter pylori and latent toxoplasmosis, age, race-ethnicity, educational attainment, economic status, and general health predict cognitive function in young and middle-aged adults. To do so, we used multivariable regression and multivariate models to analyze data obtained from the United States' National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention, which can be weighted to represent the US population. In this sample, we found that 31.6 percent of women and 36.2 percent of men of the overall sample had IgG Antibodies against Helicobacter pylori, although the seroprevalence of Helicobacter pylori varied with sociodemographic variables. There were no main effects for Helicobacter pylori or latent toxoplasmosis for any of the cognitive measures in models adjusting for age, sex, race-ethnicity, educational attainment, economic standing, and self-rated health predicting cognitive function. However, interactions between Helicobacter pylori and race-ethnicity, educational attainment, latent toxoplasmosis in the fully adjusted models predicted cognitive function. People seropositive for both Helicobacter pylori and latent toxoplasmosis - both of which appear to be common in the general population - appear to be more susceptible to cognitive deficits than are people seropositive for either Helicobacter pylori and or latent toxoplasmosis alone, suggesting a synergistic effect between these two infectious diseases on cognition in young to middle-aged adults.

Prevención de la toxoplasmosis congénita en un hospital de Buenos Aires

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Liliana Carral

2013-06-01

Full Text Available La prevención de la toxoplasmosis congénita se basa en la información de la mujer con medidas de prevención primaria, el diagnóstico serológico y el tratamiento de la embarazada y del niño. Se presentan los resultados de 12 años de implementación de un programa de prevención de la toxoplasmosis congénita, la tasa de madres infectadas, de transmisión vertical, de niños infectados y la gravedad de la afección causada. Se realizó un estudio observacional prospectivo sobre 12 035 gestantes atendidas en la maternidad del Hospital Alemán de Buenos Aires entre enero de 2000 y diciembre de 2011. Se observó una prevalencia de anticuerpos anti Toxoplasma gondii de 18.33% (2 206/12 035. Treinta y siete mujeres de 9 792 susceptibles tuvieron infección aguda, la tasa de incidencia de infección materna fue de 3.78 por 1 000 nacimientos. La tasa de transmisión transplacentaria de la infección fue 5.4% (2/37. Dos recién nacidos tuvieron toxoplasmosis congénita, uno no tuvo signos clínicos y el otro presentó coriorretinitis y estrabismo. Recibieron tratamiento 35 madres y los 2 niños con toxoplasmosis congénita. En conclusión: Las cifras de transmisión obtenida permiten considerar a este programa de prevención como un recurso válido para minimizar el impacto de la toxoplasmosis congénita.

[Integrated screening for HIV, syphilis, and toxoplasmosis among pregnant women in the Central African Republic].

Science.gov (United States)

Gamba, E P; Nambei, W S; Kamandji, L

2013-01-01

The aim of this study was to determine the prevalence of syphilis and toxoplasmosis infection in pregnant women in the Central African Republic who were and were not HIV-infected, in the framework of HIV surveillance. This case-control study included 270 HIV(+) and 217 HIV(-) pregnant women among 4 750 women who attended prenatal-care clinics throughout the Central African Republic from November 2011 through January 2012. Blood specimens were collected and serological evidence of HIV1/2 was analyzed by ELISA1 and ELISA2. The Toxoplasma gondii antibody was detected with the Toxo-Hai Fumouze(®) diagnostic kit. A VDRL test was performed to screen for syphilis in all study participants. Of the 434 samples tested, 33 (7.60%) were positive for syphilis: 21 (9.7%) among HIV(+) and 12 (5.5%) among HIV(-) women (p = 0.1031); 221 (50.90%) were positive for toxoplasmosis: 117 (53.9%) among HIV(+) and 104 (47.9%) among HIV(-) women (p = 0, 2119). Coinfection with HIV, syphilis, and toxoplasmosis was found in 6.00%. No association was found between coinfection and age, parity, and residence area. The rate of syphilis infection was very high in pregnant women living in rural areas (ORcrude = 4.37; 95% CI = 2,11, 9.05). This study showed a high prevalence of toxoplasmosis and syphilis in pregnant women in the Central African Republic, regardless of their HIV infection status. Sexually transmitted infections (STIs) are common in pregnant women living in rural areas. It may be appropriate to include routine serological screening tests to determine of toxoplasmosis, syphilis and HIV in pregnant women in this country.

Acute respiratory distress syndrome and septic shock in a cat with disseminated toxoplasmosis.

Science.gov (United States)

Evans, Natashia A; Walker, Julie M; Manchester, Alison C; Bach, Jonathan F

2017-07-01

To describe acute respiratory distress syndrome (ARDS) and septic shock in a cat with disseminated toxoplasmosis. A 2-year-old neutered male domestic shorthair cat was presented for acute respiratory distress. At the time of presentation it had been receiving cyclosporine for treatment of eosinophilic dermatitis. Thoracic radiographs revealed severe mixed nodular interstitial and alveolar patterns. An endotracheal wash was performed, which confirmed a diagnosis of pulmonary toxoplasmosis. Despite initial treatment with oxygen supplementation and intravenous clindamycin, the cat developed refractory hypoxemia and hypotension requiring mechanical ventilation and vasopressor support within 24 hours of hospital admission. Cardiac arrest occurred 56 hours after admission. Necropsy was performed and histopathology revealed protozoal organisms disseminated throughout the heart, lungs, liver, and brain. The clinical and necropsy findings presented here are consistent with ARDS secondary to disseminated toxoplasmosis in a cat. This is the first detailed report of ARDS in a cat. Toxoplasma titer testing and antimicrobial prophylaxis should be considered in cats prior to immunosuppressive treatment with cyclosporine. © Veterinary Emergency and Critical Care Society 2017.

Clinical features and outcomes in patients with disseminated toxoplasmosis admitted to intensive care: a multicenter study.

Science.gov (United States)

Schmidt, Matthieu; Sonneville, Romain; Schnell, David; Bigé, Naike; Hamidfar, Rebecca; Mongardon, Nicolas; Castelain, Vincent; Razazi, Keyvan; Marty, Antoine; Vincent, François; Dres, Martin; Gaudry, Stephane; Luyt, Charles Edouard; Das, Vincent; Micol, Jean-Baptiste; Demoule, Alexandre; Mayaux, Julien

2013-12-01

Characteristics and outcomes of adult patients with disseminated toxoplasmosis admitted to the intensive care unit (ICU) have rarely been described. We performed a retrospective study on consecutive adult patients with disseminated toxoplasmosis who were admitted from January 2002 through December 2012 to the ICUs of 14 university-affiliated hospitals in France. Disseminated toxoplasmosis was defined as microbiological or histological evidence of disease affecting >1 organ in immunosuppressed patients. Isolated cases of cerebral toxoplasmosis were excluded. Clinical data on admission and risk factors for 60-day mortality were collected. Thirty-eight patients were identified during the study period. Twenty-two (58%) had received an allogeneic hematopoietic stem cell transplant (median, 61 [interquartile range {IQR}, 43-175] days before ICU admission), 4 (10%) were solid organ transplant recipients, and 10 (27%) were infected with human immunodeficiency virus (median CD4 cell count, 14 [IQR, 6-33] cells/µL). The main indications for ICU admission were acute respiratory failure (89%) and shock (53%). The 60-day mortality rate was 82%. Allogeneic hematopoietic stem cell transplant (hazard ratio [HR] = 2.28; 95% confidence interval [CI], 1.05-5.35; P = .04) and systolic cardiac dysfunction (HR = 3.54; 95% CI, 1.60-8.10; P toxoplasmosis leading to ICU admission has a poor prognosis. Recipients of allogeneic hematopoietic stem cell transplant appear to have the highest risk of mortality. We identified systolic cardiac dysfunction as a major determinant of outcome. Strategies aimed at preventing this fatal opportunistic infection may improve outcomes.

Novel Interpretation of Molecular Diagnosis of Congenital Toxoplasmosis According to Gestational Age at the Time of Maternal Infection

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Sterkers, Yvon; Pratlong, Francine; Albaba, Sahar; Loubersac, Julie; Picot, Marie-Christine; Pretet, Vanessa; Issert, Eric; Boulot, Pierre

2012-01-01

From a prospective cohort of 344 women who seroconverted for toxoplasmosis during pregnancy, 344 amniotic fluid, 264 placenta, and 216 cord blood samples were tested for diagnosis of congenital toxoplasmosis using the same PCR assay. The sensitivity and negative predictive value of the PCR assay using amniotic fluid were 86.3% and 97.2%, respectively, and both specificity and positive predictive value were 100%. Using placenta and cord blood, sensitivities were 79.5% and 21.2%, and specificities were 92% and 100%, respectively. In addition, the calculation of pretest and posttest probabilities and the use of logistic regression allowed us to obtain curves that give a dynamic interpretation of the risk of congenital toxoplasmosis according to gestational age at maternal infection, as represented by the three sample types (amniotic fluid, placenta, and cord blood). Two examples are cited here: for a maternal infection at 25 weeks of amenorrhea, a negative result of prenatal diagnosis allowed estimation of the probability of congenital toxoplasmosis at 5% instead of an a priori (pretest) risk estimate of 33%. For an infection at 10 weeks of amenorrhea associated with a pretest congenital toxoplasmosis risk of 7%, a positive PCR result using placenta at birth yields a risk increase to 43%, while a negative result damps down the risk to 0.02%. Thus, with a molecular diagnosis performing at a high level, and in spite of the persistence of false negatives, posttest risk curves using both negative and positive results prove highly informative, allowing a better assessment of the actual risk of congenital toxoplasmosis and finally an improved decision guide to treatment. PMID:23035201

Salvage trial of trimetrexate-leucovorin for the treatment of cerebral toxoplasmosis in patients with AIDS

DEFF Research Database (Denmark)

Masur, H; Polis, M A; Tuazon, C U

1993-01-01

The clinical efficacy of trimetrexate, a dihydrofolate reductase inhibitor with potent in vitro antitoxoplasma activity, was assessed in 9 sulfonamide-intolerant patients with AIDS and biopsy-proven cerebral toxoplasmosis. The 9 patients were treated for 28-149 days with trimetrexate (30-280 mg/m2...... doses for extended periods was not associated with serious toxicity. Trimetrexate alone had dramatic but transient activity in sulfonamide-intolerant patients and thus is not adequate as single-agent therapy for AIDS-associated toxoplasmosis....

Evaluation of Cystoid Change Phenotypes in Ocular Toxoplasmosis Using Optical Coherence Tomography

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Shao, Qing; Keane, Pearse A.; Stübiger, Nicole; Joussen, Antonia M.; Sadda, Srinivas R.; Heussen, Florian M.

2014-01-01

Purpose To present unique cystoid changes occurring in patients with ocular toxoplasmosis observed in spectral domain optical coherence tomography (OCT). Methods Forty-six patients (80 eyes) with a diagnosis of ocular toxoplasmosis, who underwent volume OCT examination between January 2005 and October 2012, were retrospectively collected. Review of clinical examination findings, fundus photographs, fluorescein angiograms (FA) and OCT image sets obtained at initial visits and follow-up. Qualitative and quantitative analyses of cystoid space phenotypes visualized using OCT. Results Of the 80 eyes included, 17 eyes (15 patients) demonstrated cystoid changes in the macula on OCT. Six eyes (7.5%) had cystoid macular edema (CME), 2 eyes (2.5%) had huge outer retinal cystoid space (HORC), 12 eyes (15%) had cystoid degeneration and additional 3 eyes (3.75%) had outer retinal tubulation due to age related macular degeneration. In one eye with HORC, the lesion was seen in the photoreceptor outer segment, accompanied by photoreceptor elongation and splitting. Three eyes presented with paravascular cystoid degeneration in the inner retina without other macular OCT abnormality. Conclusions In this study, different phenotypes of cystoid spaces seen in eyes with ocular toxoplasmosis using spectral domain OCT (SD-OCT) were demonstrated. CME presented as an uncommon feature, consistently with previous findings. Identification of rare morphological cystoid features (HORC with/without photoreceptor enlongation or splitting) on clinical examination had provided evidence to previous experimental models, which may also expand the clinical spectrum of the disease. Cystoid degeneration in the inner retina next to the retinal vessels in otherwise “normal” looking macula was observed, which may suggest more often clinical evaluation for those patients. Further studies are needed to verify the relevance of cystoid features seen on SD-OCT in assisting with the diagnosis and management of

Evaluation of cystoid change phenotypes in ocular toxoplasmosis using optical coherence tomography.

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Yanling Ouyang

Full Text Available PURPOSE: To present unique cystoid changes occurring in patients with ocular toxoplasmosis observed in spectral domain optical coherence tomography (OCT. METHODS: Forty-six patients (80 eyes with a diagnosis of ocular toxoplasmosis, who underwent volume OCT examination between January 2005 and October 2012, were retrospectively collected. Review of clinical examination findings, fundus photographs, fluorescein angiograms (FA and OCT image sets obtained at initial visits and follow-up. Qualitative and quantitative analyses of cystoid space phenotypes visualized using OCT. RESULTS: Of the 80 eyes included, 17 eyes (15 patients demonstrated cystoid changes in the macula on OCT. Six eyes (7.5% had cystoid macular edema (CME, 2 eyes (2.5% had huge outer retinal cystoid space (HORC, 12 eyes (15% had cystoid degeneration and additional 3 eyes (3.75% had outer retinal tubulation due to age related macular degeneration. In one eye with HORC, the lesion was seen in the photoreceptor outer segment, accompanied by photoreceptor elongation and splitting. Three eyes presented with paravascular cystoid degeneration in the inner retina without other macular OCT abnormality. CONCLUSIONS: In this study, different phenotypes of cystoid spaces seen in eyes with ocular toxoplasmosis using spectral domain OCT (SD-OCT were demonstrated. CME presented as an uncommon feature, consistently with previous findings. Identification of rare morphological cystoid features (HORC with/without photoreceptor enlongation or splitting on clinical examination had provided evidence to previous experimental models, which may also expand the clinical spectrum of the disease. Cystoid degeneration in the inner retina next to the retinal vessels in otherwise "normal" looking macula was observed, which may suggest more often clinical evaluation for those patients. Further studies are needed to verify the relevance of cystoid features seen on SD-OCT in assisting with the diagnosis and

Induction of protective immunity against toxoplasmosis in mice by ...

African Journals Online (AJOL)

The results showed that mice immunized by pcROP1 with or without alum produced high Th1 immune response compared with control groups. This type of DNA vaccine prolonged slightly the survival time. The current study showed that ROP1 DNA vaccine can induced partial protective response against toxoplasmosis.

Anti-Toxoplasma gondii secretory IgA in tears of patients with ocular toxoplasmosis: immunodiagnostic validation by ELISA

OpenAIRE

Lynch,Maria Isabel; Malagueño,Elizabeth; Lynch,Luiz Felipe; Ferreira,Silvana; Stheling,Raphael; Oréfice,Fernando

2009-01-01

Toxoplasma gondii causes posterior uveitis and the specific diagnosis is based on clinical criteria. The presence of anti-T. gondii secretory IgA (sIgA) antibodies in patients' tears has been reported and an association was found between ocular toxoplasmosis and the anti-T. gondii sIgA isotype in Brazilian patients. The purpose of this study was to provide an objective validation of the published ELISA test for determining the presence of anti-T. gondii sIgA in the tears of individuals with o...

Histopathologically verified cerebral CT findings in AIDS

International Nuclear Information System (INIS)

Tosch, U.; Witt, H.; Iglesias-Rozas, J.R.; Ruf, B.

1990-01-01

Computer tomographic and histopathological findings in 55 patients who died of the complications of acquired immunodeficiency syndrome, were reviewed retrospectively. In 23 patients (42%) an increased space of the internal or external cerebral spinal fluid was diagnosed. 20 patients (36%) had focal lesions. We differentiated between single, multiple and ring-shaped lesions with contrast enhancement and hypodense lesions. In 12 cases (22%) no CT abnormalities were found. Focal lesions proved to be secondary to toxoplasmosis in 85%. Single lesions were never caused by toxoplasmosis. (orig.) [de

Treatment of infectious complications of acquired immunodeficiency syndrome.

Science.gov (United States)

Furio, M M; Wordell, C J

1985-01-01

The infectious complications of the acquired immunodeficiency syndrome (AIDS) are discussed, and the conventional and nonconventional therapies used for these infections are reviewed. The infections most commonly encountered in patients with AIDS are Pneumocystis carinii pneumonia (58%), Candida esophagitis (31%), toxoplasmosis (21%), cytomegalovirus infections (15%), and herpes-simplex virus infections (12%). Pneumocystis carinii pneumonia is the most common life-threatening process in these patients. Trimethoprim-sulfamethoxazole (TMP-SMZ) is considered the drug of choice for its treatment. Oral candidiasis often indicates the progression to AIDS in the high-risk populations of homosexual or bisexual men, intravenous drug abusers, and individuals with hemophilia. Nystatin suspension is commonly used to treat oral candidiasis, while Candida esophagitis demands systemic therapy with ketoconazole. Toxoplasmosis most commonly manifests itself in patients with AIDS as a cerebral mass lesion. The recommended therapy includes sulfadiazine and pyrimethamine. AIDS patients frequently experience protozoal invasion of the intestinal tract with Giardia lamblia, Isospora belli, and Cryptosporidium muris. Various drugs have been tried for these infections, including quinacrine hydrochloride, metronidazole, TMP-SMZ, and spiramycin. Cytomegalovirus (CMV) infections commonly involve the lungs, gastrointestinal tract, eyes, brain, and nervous system. Attempts to treat these disseminated CMV infections with antiviral agents, including acyclovir, have not been successful. However, acyclovir has been found beneficial in the treatment of herpes-simplex virus infections. Multiple infectious complications may occur in patients with AIDS as a result of the cellular-immune deficiency associated with this disease. Until more research is done with AIDS patients, therapy must be based on the data available from the treatment of these infections in immunosuppressed patients without AIDS.

[RELEVANT PRINCIPLES IN THE DIAGNOSIS, TREATMENT, AND PREVENTION OF TOXOPLASMOSIS DURING PREGNANCY].

Science.gov (United States)

Merzlova, N B; Serova, I A; Yagodina, A Yu

2015-01-01

A retrospective survey of the prevalence of TORCH infections among pregnant women was performed in the perinatal center, M. A. Tverye Military Sanitary Unit Nine (Perm), in June 2010 to December 2013. The survey covered 2060 women: they were all examined for cytomegalovirus, herpes simplex virus, and Toxoplasma. Antibodies to Toxoplasma gondii were detected in 28.68% (591/2060); 98.62% were found to have antibodies to herpes simplex; antibodies to cytomegalovirus were identified in 87.13% (1795/2060). Acute maternal toxoplasmosis was diagnosed by seroconversion or determination of IgM anti-Toxoplasma gondii antibodies, in the presence of a low avidity index and a four-fold increase in antibody titers, by simultaneously studying paired serum samples obtained at a 2-week interval. To confirm fetal infection, amniotic fluid PCR examination should be performed after 18 weeks' gestation. No consensus of opinion as to the principles of treatment for toxoplasmosis in pregnant women makes relevant the long-term results of antibacterial and antiprotozoal treatment cycles varying in duration and intensity. The prevention of acute toxoplasmosis in pregnant women ensures the principle of a mother's personal responsibility for infection safety of a newborn infant, which is informationally provided in health and safety fundamentals course and pregravid preparation schools.

Control of the risk of human toxoplasmosis transmitted by meat

NARCIS (Netherlands)

Kijlstra, A.; Jongert, E.

2008-01-01

One-third of the human world population is infected with the protozoan parasite Toxoplasma gondii. Recent calculations of the disease burden of toxoplasmosis rank this foodborne disease at the same level as salmonellosis or campylobacteriosis. The high disease burden in combination with

Toxoplasmosis in a patient who was immunocompetent: a case report

Directory of Open Access Journals (Sweden)

Hingwe Ameet S

2011-01-01

Full Text Available Abstract Introduction Toxoplasma gondii is an obligate intracellular protozoan that infects up to one-third of the world's population. Although this case is not the first of its kind, it is clinically important since it will help doctors keep a broad differential diagnosis in mind when attending to similar patients. Case presentation We present the case of a 20-year-old man of Middle Eastern heritage presenting with only generalized lymphadenopathy who was diagnosed with acute toxoplasmosis. Conclusion This case illustrates the important fact that toxoplasmosis can present with just simple lymphadenopathy, and thus can be confused with other infections such as Epstein-Barr virus and other mononucleosis-like illnesses such as cytomegalovirus, HIV with acute retroviral syndrome, cat scratch disease, leishmaniasis and syphilis. This case underlines why appropriate testing should be performed in confusing cases, and helps increase the knowledge about the diagnosis of this disease.

Genotyping of Toxoplasma gondii: DNA extraction from formalin-fixed paraffin-embedded autopsy tissues from AIDS patients who died by severe disseminated toxoplasmosis.

Science.gov (United States)

Bastos da Silva, Inara; Batista, Tatiana Pimental de Andrade; Martines, Roosecelis Brasil; Kanamura, Cristina Takami; Ferreira, Isabelle Martins Ribeiro; Vidal, Jose Ernesto; Pereira-Chioccola, Vera Lucia

2016-06-01

This study investigated the genetic features of Toxoplasma gondii isolated directly in autopsies of HIV-infected patients who died with severe disseminated toxoplasmosis. This retrospective analysis was conducted in a cohort of 15 HIV-infected patients with clinical and laboratory data. They had previous cerebral toxoplasmosis at least 6 months before the disseminated toxoplasmosis episode. The hypothesis was that they were infected with highly virulent parasites due to the condition in which they died. T. gondii genotyping was done directly in DNA extracted from 30 autopsy brain and lung samples (2 per patient) and mutilocus PCR-RFLP genotyping was done using 12 molecular markers. The 30 clinical samples were genotyped successfully in 8 or more loci and six suggestive genotypes were identified. One of them was Toxo DB #11, previously identified in different domestic animals and virulent in experimental animals. The other five suggestive genotypes identified in 14 patients were not described. TgHuDis1 was the most frequent and was determined in 8 patients. TgHuDis3 and TgHuDis5 were identified in two patients each. TgHuDis2 and TgHuDis4 have been identified in one patient each. These suggestive genotypes could be considered as virulent, since they caused severe tissue damage and had similar characteristics as Toxo # DB 11. Copyright © 2016 Elsevier Inc. All rights reserved.

TOXOPLASMOSIS: MORPHOLOGICAL AND MORPHOMETRIC EVALUATION OF SPINAL CORD NEURONS FROM NONSYMPTOMATIC SEROPOSITIVE DOGS

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Alessandra Cristina Francischini de Carvalho

2015-04-01

Full Text Available The aim of this work was to analyze the neuron morphology and morphometry of cervical, thoracic and lumbar areas of nonsymptomatic seropositive dogs’ spinal cord for toxoplasmosis. Twenty indefinite-breed adult dogs were used; ten dogs were healthy, with negative serology for toxoplasmosis, and were used as the control group (group 1, and ten dogs were nonsymptomatic but seropositive for toxoplasmosis (group 2. After the microtomy, with interval of 100 micrometers (µm, the histological 5-µm-thick cuts were dyed by hematoxylin-eosin and Masson's trichrome techniques. The glass slides were analyzed under light microscope to examine the neuron morphology. The parameters considered for the morphometric analysis were area, perimeter, maximum diameter, minimum diameter and shape factor of cytoplasm and nucleus of neuron. The results were statistically analyzed by Student’s t test at 5% probability level. The morphological characteristics between the two groups were similar and according to literature. The morphometric results showed that there were changes in neurons size and structure, and increase and loss of star shape were noticed in seropositive animals. The results suggest that the neurons of these dogs, yet nonsymptomatic, can have lost their conductor function.

Waterborne toxoplasmosis investigated and analysed under hydrogeological assessment: new data and perspectives for further research.

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Vieira, Flávia Pereira; Alves, Maria da Glória; Martins, Livia Mattos; Rangel, Alba Lucínia Peixoto; Dubey, Jitender Prakash; Hill, Dolores; Bahia-Oliveira, Lilian Maria Garcia

2015-11-01

We present a set of data on human and chicken Toxoplasma gondii seroprevalence that was investigated and analysed in light of groundwater vulnerability information in an area endemic for waterborne toxoplasmosis in Brazil. Hydrogeological assessment was undertaken to select sites for water collection from wells for T. gondii oocyst testing and for collecting blood from free-range chickens and humans for anti-T. gondii serologic testing. Serologic testing of human specimens was done using conventional commercial tests and a sporozoite-specific embryogenesis-related protein (TgERP), which is able to differentiate whether infection resulted from tissue cysts or oocysts. Water specimens were negative for the presence of viable T. gondii oocysts. However, seroprevalence in free-range chickens was significantly associated with vulnerability of groundwater to surface contamination (p toxoplasmosis in light of groundwater vulnerability information associated with prevalence in humans estimated by oocyst antigens recognition have implications for the potential role of hydrogeological assessment in researching waterborne toxoplasmosis at a global scale.

Intracranial toxoplasmosis presenting as panhypopituitarism in an immunocompromised patient.

Science.gov (United States)

Hamdeh, Shadi; Abbas, Anum; Fraker, Jessica; Lambrecht, J E

2015-12-01

A 37-year-old man presented with worsening headache, vomiting, and right-sided weakness over the last few weeks. A head computed tomography showed a left hemispheric posterior medial parietal lobe lesion with surrounding edema. Further imaging with magnetic resonance imaging showed multiple enhancing mass lesions. The largest lesion measured 2.4 cm within the left occipital parietal region (Figure A and B). Laboratory data showed reactive HIV antibodies, confirmed by Western blot. An absolute CD4 count was 22 cells/μL. Other laboratory test results showed low sodium, thyrotropin, FT4, FT3, cortisol levels, corticotropin, luteinizing hormone, and testosterone. Based on these findings, the brain lesions were believed to be causing his panhypopituitarism. A brain biopsy confirmed the presence of Toxoplasma gondii by polymerase chain reaction. The patient was started on pyrimethamine and clindamycin for toxoplasmosis treatment, and azithromycin and sulfamethoxazole/trimethoprime for appropriate prophylaxis. He was also started on hormone supplementation. His symptoms were completely resolved at the time of discharge.

Cutaneous toxoplasmosis in an immunosuppressed dog

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T.S. Oliveira

2014-06-01

Full Text Available A seven-year-old female spayed Schnauzer was presented with cutaneous ulcerated nodular lesions shortly after the beginning of an immunosuppressive treatment for immune-mediated hemolytic disease. Cytology was performed and a great number of neutrophils and banana-shaped organisms were observed. Biopsy showed a neutrophilic and histiocytic dermatitis and panniculitis with myriads of intralesional bradyzoites cysts and tachyzoites. PCR analysis was positive for Toxoplasma gondii and negative for Neospora caninum. Immunohistochemistry confirmed intralesional T. gondii antigens. This study reports a rare case of cutaneous toxoplasmosis in an immunosuppressed dog.

Toxoplasmosis serology: an efficient hemagglutination procedure to detect IgG and IgM antibodies

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M.E. Camargo

1989-08-01

Full Text Available In search of an efficient but simple, low cost procedure for the serodiagnosis of Toxoplasmosis, especially suited for routine laboratories facing technical and budget limitations as in less developed countries, the diagnostic capability of Hematoxo® , an hemagglutination test for toxoplasmosis, was evaluated in relation to a battery of tests including IgG- and IgM-immunofluorescence tests, hemagglutination and an IgM-capture enzymatic assay. Detecting a little as 5 I.U. of IgG antitoxoplasma antibodies, Hematoxo® showed a straight agreement as to reactivity and non-reactivity for the 443 non-reactive and the 387 reactive serum samples, included in this study. In 23 cases presenting a serological pattern of acute toxoplasmosis and showing IgM antibodies, Hematoxo® could detect IgM antibodies in 18, indicated by negativation or a significant decrease in titers as a result of treating samples with 2-mercapto-ethanol. However, a neat increase in sensitivity for IgM specific antibodies could be achieved by previously removing IgG from the sample, as demonstrated in a series of acute toxoplasmosis sera. A simple procedure was developed for this purpose, by reconstituting a lyophilized suspension of Protein A - rich Staphylococcus with the lowest serum dilution to be tested. Of low cost and easy to perform, Hematoxo® affords not only a practical qualitative procedure for screening reactors and non-reactors, as in prenatal services, but also quantitative assays that permit to titrate antibodies as well as to identify IgM antibodies.

Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

International Nuclear Information System (INIS)

Schroeder, Paul C.; Donovan Post, M. Judith; Bruce-Gregorios, Jocelyn; Oschatz, Elizabeth; Stadler, Alfred; Thurnher, Majda M.

2006-01-01

Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma. (orig.)

Analysis of the utility of diffusion-weighted MRI and apparent diffusion coefficient values in distinguishing central nervous system toxoplasmosis from lymphoma

Energy Technology Data Exchange (ETDEWEB)

Schroeder, Paul C.; Donovan Post, M. Judith; Bruce-Gregorios, Jocelyn [University of Miami, Jackson Memorial Hospital, Miami, FL (United States); Oschatz, Elizabeth; Stadler, Alfred; Thurnher, Majda M. [Medical University of Vienna, Department of Radiology Neuroradiology Section, Vienna (Austria)

2006-10-15

Toxoplasmosis and lymphoma are common lesions of the central nervous system in patients with AIDS. It is often difficult to distinguish between these lesions both clinically and radiographically. Previous research has demonstrated restricted diffusion within cerebral lymphomas and bacterial abscesses. However, little work has been done to evaluate the diffusion characteristics of toxoplasmosis lesions. This study was designed to explore further the utility of diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps and values in making the distinction between toxoplasmosis and lymphoma. The magnetic resonance imaging (MRI) studies of 36 patients, including 22 with toxoplasmosis (all of whom had AIDS) and 14 with lymphoma (8 of whom had AIDS), at two institutions were reviewed retrospectively. The characteristics of the lesions on DWI were evaluated, and the ADC ratios of the lesions were calculated and compared. There was significant overlap of the ADC ratios of toxoplasma and lymphoma, most notably in the intermediate (1.0-1.6) range. There was variability in ADC ratios even among different lesions in the same patient. In only a minority of the lymphoma patients were the ADC ratios low enough to suggest the correct diagnosis. Our study showed that toxoplasmosis exhibits a wide spectrum of diffusion characteristics with ADC ratios which have significant overlap with those of lymphoma. Therefore, in the majority of patients, ADC ratios are not definitive in making the distinction between toxoplasmosis and lymphoma. (orig.)

[Congenital toxoplasmosis: randomised comparison of strategies for retinochoroiditis prevention].

Science.gov (United States)

Wallon, Martine; Kieffer, François; Binquet, Christine; Thulliez, Philippe; Garcia-Méric, Patricia; Dureau, Pascal; Franck, Jacqueline; Peyron, François; Bonnin, Alain; Villena, Isabelle; Bonithon-Kopp, Claire; Gouyon, Jean-Bernard; Masson, Sandrine; Félin, Alexandrin; Cornu, Catherine

2011-01-01

In France, children with confirmed congenital toxoplasmosis receive a treatment for a period of 12 to 24 months. Such prolonged treatment may generate potentially severe risks, in particular hematologic and cutaneous. Our objective is to compare the effectiveness of two therapeutic strategies on the prevention of retinochoroiditis by a randomized, non-inferiority, open-label, parallel study including 486 children, 3 to 6 months of age with a non-severe form of congenital toxoplasmosis. Following randomization, pyrimethamine-sulphonamide treatment is initiated for a period of three months, followed by a treatment with Fansidar(®) for 9 months, or therapeutic abstention. Follow-up visits during a two-year period will include an examination of the eye, a blood test, and questionnaires to evaluate the children's quality of life and their parents' anxiety. Confirming the non-inferiority of the effectiveness of a short-term treatment will improve the quality of life of parents and children. © 2011 Société Française de Pharmacologie et de Thérapeutique.

Epidemiological review of toxoplasmosis in humans and animals in Romania.

Science.gov (United States)

Dubey, J P; Hotea, I; Olariu, T R; Jones, J L; Dărăbuş, G

2014-03-01

Infections by the protozoan parasite Toxoplasma gondii are widely prevalent in humans and other animals worldwide. However, information from eastern European countries is sketchy. In many eastern European countries, including Romania, it has been assumed that chronic T. gondii infection is a common cause of infertility and abortion. For this reason, many women in Romania with these problems were needlessly tested for T. gondii infection. Most papers on toxoplasmosis in Romania were published in Romanian in local journals and often not available to scientists in other countries. Currently, the rate of congenital infection in Romania is largely unknown. In addition, there is little information on genetic characteristics of T. gondii or prevalence in animals and humans in Romania. In the present paper we review prevalence, clinical spectrum and epidemiology of T. gondii in humans and animals in Romania. This knowledge should be useful to biologists, public health workers, veterinarians and physicians.

Toxoplasmosis a re-emerging ancient disease | Neils | Zoologist (The)

African Journals Online (AJOL)

Toxoplasmosis a re-emerging ancient disease. JS Neils, IA Lawal. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/tzool.v4i1.45219 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

Evaluation of the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers: a systematic review and documentary analysis.

Science.gov (United States)

McGraw, Caroline; Drennan, Vari M

2015-02-01

To evaluate the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers. The objective was to identify the extent to which these frameworks take account of the setting where the ulcer originated as being the person's home rather than a hospital setting. Pressure ulcers involving full-thickness skin loss are increasingly being regarded as indicators of nursing patient safety failure, requiring investigation using root cause analysis frameworks. Evidence suggests that root cause analysis frameworks developed in hospital settings ignore the unique dimensions of risk in home healthcare settings. A systematic literature review and documentary analysis of frameworks used to investigate community-acquired grade three and four pressure ulcers by home nursing services in England. No published papers were identified for inclusion in the review. Fifteen patient safety investigative frameworks were collected and analysed. Twelve of the retrieved frameworks were intended for the investigation of community-acquired pressure ulcers; seven of which took account of the setting where the ulcer originated as being the patient's home. This study provides evidence to suggest that many of the root cause analysis frameworks used to investigate community-acquired pressure ulcers in England are unsuitable for this purpose. This study provides researchers and practitioners with evidence of the need to develop appropriate home nursing root cause analysis frameworks to investigate community-acquired pressure ulcers. © 2014 John Wiley & Sons Ltd.

Prenatal diagnosis of congenital toxoplasmosis: comparative value of fetal blood and amniotic fluid using serological techniques and cultures.

Science.gov (United States)

Fricker-Hidalgo, H; Pelloux, H; Muet, F; Racinet, C; Bost, M; Goullier-Fleuret, A; Ambroise-Thomas, P

1997-09-01

The prenatal diagnosis of congenital toxoplasmosis is mainly based on biological tests performed on fetal blood and amniotic fluid. We studied the performance of neonatal diagnosis procedures and the results of fetal blood and amniotic fluid analysis. Of 127 women who contracted toxoplasmosis and underwent prenatal diagnosis, the postnatal serological follow-up was long enough to definitively diagnose congenital toxoplasmosis in 19 cases and to exclude it in 27 cases. Prenatal diagnosis allowed the detection of 94.7 per cent (18/19) of the infected fetuses. The sensitivities of tests in amniotic fluid and fetal blood were equivalent, 88.2 per cent (15/17) and 87.5 per cent (14/16), respectively. In fetal blood, biological techniques were positive in 12/16 cases and in 2/16 cases, serological tests were the only positive sign. The specificities of tests in amniotic fluid and fetal blood were respectively 100 per cent (23/23) and 86.3 per cent (19/22) (three false-positive serological results). These results, added to the lower morbidity of amniocentesis compared with cordocentesis, might lead to cordocentesis being abandoned in the prenatal diagnosis of congenital toxoplasmosis.

Early diagnosis and successful treatment of disseminated toxoplasmosis after cord blood transplantation.

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Kurihara, Taro; Sumi, Masahiko; Kaiume, Hiroko; Takeda, Wataru; Kirihara, Takehiko; Sato, Keijiro; Ueki, Toshimitsu; Hiroshima, Yuki; Ueno, Mayumi; Ichikawa, Naoaki; Kaneko, Yumi; Hikosaka, Kenji; Norose, Kazumi; Kobayashi, Hikaru

2016-06-01

A 66-year-old woman with refractory angioimmunoblastic T-cell lymphoma underwent cord blood transplantation. Prior to transplantation, a serological test for Toxoplasma gondii-specific IgG antibodies was positive. On day 96, she exhibited fever and dry cough. Chest CT showed diffuse centrilobular ground glass opacities in both lungs. The reactivation of T. gondii was identified by the presence of parasite DNA in peripheral blood and bronchoalveolar lavage fluid. Moreover, brain MRI revealed a space occupying lesion in the right occipital lobe. Therefore, disseminated toxoplasmosis was diagnosed. She received pyrimethamine and sulfadiazine from day 99. The lung and brain lesions both showed improvement but the PCR assay for T. gondii DNA in peripheral blood was positive on day 133. On day 146, she developed blurred vision and reduced visual acuity, and a tentative diagnosis of toxoplasmic retinochoroiditis was made based on ophthalmic examination results. As agranulocytosis developed on day 158, we decided to discontinue pyrimethamine and sulfadiazine and the treatment was thus switched to atovaquone. Moreover, we added spiramycin to atovaquone therapy from day 174, and her ocular condition gradually improved. In general, the prognosis of disseminated toxoplasmosis after hematopoietic stem cell transplantation (HSCT) is extremely poor. However, early diagnosis and treatment may contribute to improvement of the fundamentally dismal prognosis of disseminated toxoplasmosis after HSCT.

Cholestasis caused by panhypopituitarism and acquired cytomegalovirus infection in a 2-month-old male infant: A case report.

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Chan, U; Chan, Wai-Tao; Ting, Wei-Hsin; Ho, Che-Sheng; Liu, Hsi-Che; Lee, Hung-Chang

2017-04-01

Septo-optic dysplasia (SOD) is a rare congenital disorder that may cause jaundice in infants. However, it is usually prone to neglect and misdiagnosis in infants with cholestasis because endocrine disorder such as panhypopituitarism is rare in the cause of infantile cholestasis. We report a case of SOD concurrent with acquired cytomegalovirus (CMV) infection, who presented with prolonged jaundice as the first clinical sign. The patient was a 2-month-old male infant who presented with cholestasis, combined with fever and panhypopituitarism. He was diagnosed with SOD and acquired CMV infection. He was treated with hormone replacement therapy and ganciclovir. After correction of the pituitary hormone deficiency and ganciclovir treatment, significant improvements of cholestasis, retinal lesions, and growth rate were seen in our patient. Although an endocrine disorder such as panhypopituitarism is rare in the cause of neonatal or infantile cholestasis, we must keep this reason in mind.

Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy.

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Valentini, P; Buonsenso, D; Barone, G; Serranti, D; Calzedda, R; Ceccarelli, M; Speziale, D; Ricci, R; Masini, L

2015-02-01

To compare the effectiviness of spiramycin/cotrimoxazole (Sp/C) versus pyrimethamine/sulfonamide (Pyr/Sul) and spiramycin alone (Spy) on mother-to-child transmission of toxoplasmosis infection in pregnancy. Retrospective study of pregnant women evaluated for suspected toxoplasmosis between 1992 and 2011. A total of 120 mothers and their 123 newborns were included. Prenatal treatment consisted of spiramycin in 43 mothers (35%), spiramycin/cotrimoxazole in 70 (56.9%) and pyrimethamine/sulfonamide in 10 (8.1%). A trend toward reduction in toxoplasmosis transmission was found when Sp/C was compared with Pyr/Sul and particularly with Spy alone (P=0.014). In particular, Spy increased the risk of congenital infection when compared with Sp/C (odds ratio (OR) 4.368; 95% CI: 1.253 to 15.219), but there was no significant reduction when Sp/C was compared with Pyr/Sul (OR 1.83; 95% CI: 0.184 to 18.274). The treatment based on Sp/C has significant efficacy in reducing maternal-fetal transmission of Toxoplasma gondii when compared with Pyr/Sul and particularly to Spy. Randomized controlled trials would be required.

[Serological Investigation of Toxoplasma gondii on Pregnant Women and Toxoplasmosis Suspected Patients Between 2012-2014 Years on a Tertiary Training Hospital].

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Selek, Mehmet Burak; Bektöre, Bayhan; Baylan, Orhan; Özyurt, Mustafa

2015-09-01

Toxoplasmosis is a zoonotic disease which is still an important health issue in both developing and developed countries. We aimed to evaluate Toxoplasma gondii (T. gondii) seropositivity on toxoplasmosis suspected patients and pregnant women, retrospectively. Blood samples taken from toxoplasmosis suspected patients (n=1296) and pregnant women (1737) on our tertiary training hospital between 2012-2014 years. Anti-T. gondii IgG and IgM seropositivity analyzed with chemiluminescent microparticle immunological assay (CMIA) method. Also IgG avidity index were evaluated on patients who had both antibodies. Of 1269 toxoplasmosis suspected patients, 37% (n=479) had only T. gondii IgG positive while 1.9% (n=25) had both IgG and IgM antibodies. Of 1737 pregnant women, 24.2% (n=421) had only T. gondii IgG positive while 0.7% (n=13) of women were found positive for both antibodies. None of the total 3033 patients were seropositive for sole IgG antibody. Avidity tests were applied to the double positive patients and low avidity were detected on only one person from each group. Nationwide, high throughput, systemic seroprevalance studies is needed in order to take precautions for the public health to protect sensitive groups and pregnant women especially because of congenital toxoplasmosis risk.

Toxoplasmosis among pregnant women: high seroprevalence and risk factors in Kinshasa, Democratic Republic of Congo.

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Doudou, Yobi; Renaud, Piarroux; Coralie, L'Ollivier; Jacqueline, Franck; Hypolite, Situakibanza; Hypolite, Muhindo; Patrick, Mitashi; Andreia, Inocêncio da Luz Raquel; Van Sprundel, Marc; Marleen, Boelaert; Van Geertruyden, Jean-Pierre; Pascal, Lutumba

2014-01-01

To determine the seroprevalence of toxoplasmosis in pregnant women, as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo. Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate. They were interviewed with a structured questionnaire about known risk factors (age, meat consumption, contact with soil, and presence of cat) and a venous blood sample was taken. Sera were analysed for total immunoglobulins (Ig) by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay. IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity. A total of 781 women were included. Median age was 28 years old (IQR: 8.5). And 627 women (80.3%; 95% CI: 77.5-83.1) were found to be positive to total Ig and 17 out of 387 (4.4%; 95% CI: 2.3-6.4) were positive to IgM. IgG avidity was low for 2 (11.8%) women, intermediate for 2 (11.8%) and high for 13 women (76.4%). There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed. In Kinshasa, toxoplasmosis endemicity is highly prevalent. One woman out of twenty five had a recent toxoplasmosis infection and 20% were not protected against primo-infection, indicating a need for measures to prevent and control toxoplasmosis during pregnancy. Copyright © 2014 Asian Pacific Tropical Biomedical Magazine. Published by Elsevier B.V. All rights reserved.

Deficiência auditiva na toxoplasmose congênita detectada pela triagem neonatal Hearing loss in congenital toxoplasmosis detected by newborn screening

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Gláucia Manzan Queiroz de Andrade

2008-02-01

Full Text Available A toxoplasmose congênita pode causar déficit neurossensorial em até 20% dos casos e o tratamento no primeiro ano de vida melhora o prognóstico. No Brasil, desconhece-se o impacto da infecção na hipoacusia. OBJETIVO: Avaliar a audição de crianças com toxoplasmose congênita identificadas pela triagem neonatal. MATERIAL E MÉTODO: Estudo prospectivo de crianças com toxoplasmose congênita identificadas pela triagem neonatal (IgM anti-T. gondii em Belo Horizonte, durante 2003/2004. Realizada sorologia confirmatória (mãe/filho e consideradas positivas as crianças apresentando IgM e/ou IgA nos primeiros seis meses ou IgG aos 12 meses de vida. Avaliações auditivas ao diagnóstico e após 12 meses incluíram Audiometria Comportamental, Emissões Otoacústicas, Imitanciometria, Audiometria de Tronco Encefálico. RESULTADOS: Dentre 30.808 crianças triadas (97% dos nascidos vivos, 20 apresentavam toxoplasmose congênita, 15 (75% com infecção subclínica. Dezenove crianças realizaram avaliação auditiva. Quatro apresentaram déficit neurossensorial (21,1%. Uma criança apresentou outros fatores de risco para hipoacusia; nas outras três, a toxoplasmose foi o único fator observado. Duas crianças, tratadas adequadamente com antiparasitários, apresentaram déficit auditivo, em desacordo com a literatura. CONCLUSÃO: Os achados sugerem que a toxoplasmose congênita, prevalente no Brasil, é um fator de risco para hipoacusia e o impacto dessa infecção nas perdas auditivas deve ser estudado.Congenital toxoplasmosis may cause sensorineural deficit in up to 20% of the patients and proper treatment in the first year improves prognosis. In Brazil, this infection’s impact on hearing impairment is unknown. AIM: To evaluate hearing of newborns with congenital toxoplasmosis identified by the newborn screening service. METHOD: This prospective study analyzed children with congenital toxoplasmosis identified by newborn screening (IgM anti

Early diagnosis of congenital toxoplasmosis in newborn infants using IgG subclasses against two Toxoplasma gondii recombinant proteins

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Carlos Henryque de Souza e Silva

2012-05-01

Full Text Available The aim of this work was to evaluate the utility of ELISA-based testing of total IgG (IgGt antibodies and its subclasses (IgG1, IgG2, IgG3 and IgG4 against soluble (STAg and recombinant (rSAG1 and rMIC3 antigens of Toxoplasma gondii for diagnosing congenital toxoplasmosis. Sera from 217 newborns initially testing positive for specific IgM in filter paper dried blood spots were tested for specific IgM and IgG by ELFA-VIDAS®. Congenital toxoplasmosis was confirmed in 175 and ruled out in 42 infants. The validity of the ELISA tests was determined using the persistence of IgG antibodies (ELFA-VIDAS® kit at the end of 12 months, which is considered the reference test for the diagnosis of congenital toxoplasmosis. The frequency of positivity with IgGt against STAg, rSAG1 and rMIC3 was found in 97.2%, 96.3% and 80.2%, respectively, of the newborns with confirmed congenital toxoplasmosis. IgG1 reacted with all three antigens, while IgG3 and IgG4 reacted preferentially with rMIC3. Higher mean values of reactivity (sample optical density/cut-off were found for all subclasses when using rMIC3. All of the antigens showed high sensitivity and low specificity in detecting anti-T. gondii IgGt and IgG1 and low sensitivity and high specificity in detecting IgG3 and IgG4. In conclusion, the combined detection of IgG antibody subclasses against recombinant toxoplasmic antigens may be useful for the early diagnosis of congenital toxoplasmosis.

Adverse Socioeconomic Conditions and Oocyst-Related Factors Are Associated with Congenital Toxoplasmosis in a Population-Based Study in Minas Gerais, Brazil

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Carellos, Ericka Viana Machado; de Andrade, Gláucia Manzan Queiroz; Vasconcelos-Santos, Daniel Vitor; Januário, José Nélio; Romanelli, Roberta Maia Castro; Abreu, Mery Natali Silva; da Silva, Fabiana Maria; Loures, Ivy Rosa Coelho; de Andrade, Juliana Queiroz; Caiaffa, Waleska Teixeira

2014-01-01

Objective Congenital toxoplasmosis is a public health problem in Brazil. This study aimed to determine risk factors associated with congenital toxoplasmosis in Minas Gerais which is the second largest Brazilian State based on number of inhabitants, and its territorial extension is larger than that of France. Methods: Population-based case-control study to assess the association between congenital toxoplasmosis and maternal exposure to infection risk factors. The study included mothers/children participating in the Minas Gerais Newborn Screening Program. The cases consisted of 175 mothers of infected children, and the controls consisted of 278 mothers of children without suspected infection. The associations were assessed through binomial logistic regression with p≤0.05. Results The variables associated with lower probability of toxoplasmosis were: older mother age (OR = 0.89; CI95% = 0.85–0.93), higher level of education (OR = 0.85; CI95% = 0.78–0.92), access to potable water (OR = 0.21; CI95% = 0.08–0.51), and home with flush toilet (OR = 0.18; CI95% = 0.04–078). The variables associated with higher probability of infection were: cats in the neighborhood (OR = 2.27; CI95% = 1.27–4.06), owning or visiting homes with domestic cats (OR = 1.90; CI95% = 1.09–3.31), handling the soil (OR = 2.29; CI95% = 1.32–3.96), and eating fresh meat not previously frozen (OR = 3.97; CI95% = 2.17–7.25). After stratification according region of residence (rural or urban/peri-urban), home with flush toilet and consumption of treated water were protective against the disease only in the rural stratum. Conclusions In Minas Gerais, congenital toxoplasmosis has been associated with poor socioeconomic conditions. Considering maternal exposure to sources of Toxoplasma gondii, the predominating risk factors were those related to the ingestion of oocysts. It is expected that these results will contribute to

Acute disseminated toxoplasmosis in a juvenile cheetah (Acinonyx jubatus).

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Lloyd, Christopher; Stidworthy, Mark F

2007-09-01

A juvenile cheetah (Acinonyx jubatus) died with rapidly progressive pyrexia, tachypnea, abdominal effusion, and hepatomegaly. Postmortem examination revealed lesions consistent with acute disseminated infection with Toxoplasma gondii. The presence of this organism was confirmed in multiple organs by immunohistochemistry and polymerase chain reaction. To the best of our knowledge, we propose this to be the first reported case of primary acute disseminated toxoplasmosis in a cheetah.

[Importance of medical education in the diagnosis of toxoplasmosis in Cuba].

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Gavito, Dora Emma Ginorio; Duque, María Victoria Rodríguez; Iraola, Raimundo Cox; Galindo, Luis Fonte; Rivero, Lázara Rojas

2003-01-01

The results of the National Toxoplasmosis Reference Laboratory during 1999 and 2000 were processed and the evaluations on this topic were simultaneously analyzed among 51 professionals that attended the First National Workshop held at "Pedro Kouri" Institute of Tropical Medicine at that time. Of 3 672 orders, 3 171 (86.3%) did not have the reason for serology, 36.1% had no place of origin and only 301 cases (8.1%) were indicated the matched serum. On analyzing the main causes leading to make this test, 13.5% corresponded to repeated abortions, which is not accepted at present as a clinical manifestation in the course of the disease. Coincidentally, when some professionals were evaluated through a survey about the basic aspects related to this parasitosis, only 31.3% were able to obtain satisfactory marks. Most of the mistakes were observed in the interpretation of the laboratory results.

Toxoplasmosis in the Eastern Grey Kangaroo, Macropus giganteus and the Cape Hyrax, Procavis capensis in Japan

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Khaled Mohamed El-Dakhly1,4, Nagwan El-Habashi2, El-Shaymaa El-Nahass3,4, Hiroki Sakai4 and Tokuma Yanai4,*

2013-11-01

Full Text Available Toxoplasmosis was investigated in an eastern grey kangaroo, Macropus giganteus, and four cape hyraxes, Procavia capensis, in a Japanese zoo. Clinically, the kangaroo showed neurological signs, emaciation, diarrhea, elevated AST and CK, and subjected to coma before death. One young cape hyrax had severe anorexia, while the other three died without exhibiting clinical signs. Grossly, lungs of the kangaroo were dark red in color, while hyraxes, besides, showed hepatic multifocal white foci, and intestinal multifocal hemorrhages. Histologically, the kangaroo had frequent Toxoplasma gondii pseudocysts in brain, heart and skeletal muscles. All hyraxes had multifocal necrosis with cysts containing numerous bradyzoites in liver and spleen, along with necrotic gastroenteritis and intestinal hemorrhages. Immunohistochemically, cysts showed positive reaction to anti-T. gondii antibodies. These findings indicate possible outbreaks of toxoplasmosis in eastern grey kangaroos and cape hyraxes, zoo habitants; therefore, they could be susceptible intermediate hosts for T. gondii in terms of zoonosis. This is the first report of toxoplasmosis in eastern grey kangaroos and cape hyraxes in Japanese zoos.

Toxoplasmosis awareness, seroprevalence and risk behavior among pregnant women in the Gampaha district, Sri Lanka.

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Chandrasena, Nilmini; Herath, Rasika; Rupasinghe, Nawamalika; Samarasinghe, Buddhini; Samaranayake, Hasaranga; Kastuririratne, Anuradhani; de Silva, Nilanthi Renuka

2016-03-01

Primary gestational toxoplasmosis can be transmitted to the fetus with deleterious effects on the pregnancy. There is very little information regarding gestational toxoplasmosis in Sri Lanka. This survey was done to determine the prevalence and awareness of toxoplasmosis and to identify risk factors of infection among pregnant women in the Gampaha district, Sri Lanka. Women attending obstetric clinics at the Colombo North Teaching Hospital in 2014 were tested for Toxoplasma gondii (T. gondii) specific Immunoglobulins G (IgG) and M (IgM) subtypes using the OnSite Toxo IgG/IgM Rapid Test-Dip Strip(®). Disease awareness and risk behaviors of the participants were investigated. Of the 293 participants (mean age 27 years, SD ± 5.92), 38% were primigravidae with a mean gestational age of 16.2 weeks (SD 7). The prevalence of anti-T. gondii IgG and IgM antibodies was 12.3% (n = 36) and zero, respectively. Unadjusted and adjusted odds ratios were calculated to determine risk factors of infection (cat-ownership, handling cats, consumption of meat, commercial meals and unwashed raw vegetables and fruits, handling soil and not washing hands after handling soil). On bivariate analysis, eating commercially prepared meals weekly or more was associated with toxoplasma seroprevalence with marginal statistical significance. On multivariate analysis, none of the considered risk factors were significant. Toxoplasma awareness was 4.4% (n = 13); health personnel (46.2%, n = 6) and media (53.8%, n = 7) being sources of information. Health education programs to increase awareness of toxoplasmosis is recommended at antenatal clinics.

Cerebral toxoplasmosis in AIDS - computerized tomography evaluation; Toxoplasmose cerebral na SIDA - avaliacao por tomografia computadorizada

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Alves, Regina Coeli Fonseca [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Hospital Universitario Antonio Pedro. Servico de Radiologia; Narchiori, Edson [Universidade Federal Fluminense, Niteroi, RJ (Brazil). Dept. de Radiologia

1999-06-01

Cerebral toxoplasmosis is a disease that affects many AIDS's patients. FOr this paper 46 patients with confirmed cases of cerebral toxoplasmosis who did a CT scan between March, 1994 and September, 1997 were examined. Single lesions were found in 28.3% of the patients. The lesions were more frequently detected in the basal ganglia and the frontal lobes. No lesion was larger than 4 cm. As regards the contrast enhancing of the lesions on a CT scan we observed that 54.5% of the lesions had a ring-like contrast enhancing, 36.4% had a nodular contrast enhancing and 6% had a heterogeneous form. After the 21st day of treatment we noticed an improvement in the aspect of the patients'lesions. The improvement of the lesions could be seen through a reduction of the edematous halo, a reduction of the lesion size and a modification in the contrast enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility enhancing on the CT scan. The CT scan was an important method to demonstrate the lesions compatibility with cerebral toxoplasmosis, as well as to monitor these patients during treatment. (author)

Molecular diagnosis of symptomatic toxoplasmosis: a 9-year retrospective and prospective study in a referral laboratory in São Paulo, Brazil.

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Camilo, Lilian Muniz; Pereira-Chioccola, Vera Lucia; Gava, Ricardo; Meira-Strejevitch, Cristina da Silva; Vidal, Jose Ernesto; Brandão de Mattos, Cinara Cássia; Frederico, Fábio Batista; De Mattos, Luiz Carlos; Spegiorin, Lígia Cosentino Junqueira Franco

Symptomatic forms of toxoplasmosis are a serious public health problem and occur in around 10-20% of the infected people. Aiming to improve the molecular diagnosis of symptomatic toxoplasmosis in Brazilian patients, this study evaluated the performance of real time PCR testing two primer sets (B1 and REP-529) in detecting Toxoplasma gondii DNA. The methodology was assayed in 807 clinical samples with known clinical diagnosis, ELISA, and conventional PCR results in a 9-year period. All samples were from patients with clinical suspicion of several features of toxoplasmosis. According to the minimum detection limit curve (in C T ), REP-529 had greater sensitivity to detect T. gondii DNA than B1. Both primer sets were retrospectively evaluated using 515 DNA from different clinical samples. The 122 patients without toxoplasmosis provided high specificity (REP-529, 99.2% and B1, 100%). From the 393 samples with positive ELISA, 146 had clinical diagnosis of toxoplasmosis and positive conventional PCR. REP-529 and B1 sensitivities were 95.9% and 83.6%, respectively. Comparison of REP-529 and B1 performances was further analyzed prospectively in 292 samples. Thus, from a total of 807 DNA analyzed, 217 (26.89%) had positive PCR with, at least one primer set and symptomatic toxoplasmosis confirmed by clinical diagnosis. REP-529 was positive in 97.23%, whereas B1 amplified only 78.80%. After comparing several samples in a Brazilian referral laboratory, this study concluded that REP-529 primer set had better performance than B1 one. These observations were based after using cases with defined clinical diagnosis, ELISA, and conventional PCR. Copyright © 2017 Sociedade Brasileira de Infectologia. Published by Elsevier Editora Ltda. All rights reserved.

Fatal toxoplasmosis in a southern muriqui (Brachyteles arachnoides) from São Paulo state, Brazil: Pathological, immunohistochemical, and molecular characterization.

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Santos, Stéfanie Vanessa; Pena, Hilda F J; Talebi, Mauricio G; Teixeira, Rodrigo H F; Kanamura, Cristina T; Diaz-Delgado, Josué; Gennari, Solange M; Catão-Dias, José Luiz

2018-04-01

We report the pathological, immunohistochemical, and molecular features of fatal acute systemic toxoplasmosis in an adult, female, free-living southern muriqui (Brachyteles arachnoides) from São Paulo state, Brazil. PCR-RFLP genotyping analysis identified the #21 genotype of Toxoplasma gondii. This represents the first report of acute toxoplasmosis involving this genotype in humans and animals. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Towards vaccine against toxoplasmosis: evaluation of the immunogenic and protective activity of recombinant ROP5 and ROP18 Toxoplasma gondii proteins.

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Grzybowski, Marcin M; Dziadek, Bożena; Gatkowska, Justyna M; Dzitko, Katarzyna; Długońska, Henryka

2015-12-01

Toxoplasmosis is one of the most common parasitic infections worldwide. An effective vaccine against human and animal toxoplasmosis is still needed to control this parasitosis. The polymorphic rhoptry proteins, ROP5 and ROP18, secreted by Toxoplasma gondii during the invasion of the host cell have been recently considered as promising vaccine antigens, as they appear to be the major determinants of T. gondii virulence in mice. The goal of this study was to evaluate their immunogenic and immunoprotective activity after their administration (separately or both recombinant proteins together) with the poly I:C as an adjuvant. Immunization of BALB/c and C3H/HeOuJ mice generated both cellular and humoral specific immune responses with some predominance of IgG1 antibodies. The spleen cells derived from vaccinated animals reacted to the parasite's native antigens. Furthermore, the immunization led to a partial protection against acute and chronic toxoplasmosis. These findings confirm the previous assumptions about ROP5 and ROP18 antigens as valuable components of a subunit vaccine against toxoplasmosis.

An unusual cause of community-acquired pneumonia

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Jaimie Mittal

2018-01-01

Full Text Available We present a case of fatal community-acquired pneumonia (CAP due to Acinetobacter baumannii, which is rarely reported in the northeastern United States. Previously reported cases originate from tropical and subtropical climates, and infection tends to have an aggressive course with a poor outcome. Appropriate antimicrobial therapy is crucial; however, the associated systemic inflammatory response may overwhelm host defenses, especially in patients with certain co-morbidities.

CT manifestation of congenital toxoplasmosis infection of the brain (report of 42 cases)

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Wang Zhenyu; Li Shuxin; Feng Kun

1997-01-01

To improve the recognition and diagnosis of congenital toxoplasmosis infection of the brain, forty-two cases of congenital toxoplasmosis infection of the brain verified by serological tests and initially investigated by CT were retrospectively studied. The main diagnostic feature of the entity included: (1) Widely scattered small nodular or curvilinear calcifications involving the basal ganglia, subependymal region and the frontal or parietal lobes; (2) Small patches of low density foci located at the paraventricular and gray-white matter junction area with some enhancement surrounding the foci after contrast media administration; (3) Evidence of obstructive hydrocephalus and (4) Complications of CNS malformation or developmental problems. Conclusion: CT was one of the best methods for the diagnosis of this entity, however, it should be closely correlated with the results from serological tests

Clinical and Some Laboratory Findings in Cats with Toxoplasmosis

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Bastan, Idil

2018-01-01

Objectives: The aim of this study wasto draw attention to the clinical course of the disease and some laboratoryfindings in cats diagnosed with Toxoplasmosis.Materials and Methods: Toxoplasma gondiiseropositive 14 cats were used in this study.  A serologicalevaluation was carried out to determine the presence of Toxoplasmagondii specific IgG using commercial diagnostic kits, by theenzyme-linked immunosorbent assay method. Hematological andclinical changes of those cats were recorded. Results:...

Toxoplasmosis in distemper virus infected dogs/ Toxoplasmose em cães co-infectados com o vírus da cinomose

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Aristeu Vieira da Silva

2002-05-01

Full Text Available This report shows four cases of dog´s toxoplasmosis, pointing that the neurologic signalment of toxoplasmosis and distemper is quite indistinguishable. The anmnestic data of flesh-eating and cat contact is linked with easier suspect of toxoplasmosis, reinforced by the presence of linfadenopathy, pneumonia and neurologic signs. A treatment proposal is offered, being a preventive measure to toxoplasmosis in distemper dogs, according to the clinician diagnostic conditions.Relatam-se quatro casos de toxoplasmose em cães, evidenciando-se a sintomatologia nervosa indistinguível daquela causada pela cinomose de forma isolada e mostrando a ocorrência concomitante das duas enfermidades. Sugere-se que os dados de anamnese, como hábitos de carnivorismo e contato com gatos, aliados a sinais clínicos como linfadenopatia, pneumonia, secreção ocular purulenta e distúrbios neurológicos, favoreçam a suspeita clínica de toxoplasmose. Propõe-se um tratamento, preventivo para a toxoplasmose, nos cães com cinomose, baseado nas condições de diagnóstico disponíveis pelo clínico.

Toxoplasmosis: The value of molecular methods in diagnosis compared to conventional methods

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Zineb Tlamçani

2013-06-01

Full Text Available Toxoplasmosis is a parasitic infection due to Toxoplasma gondii an obligate intracellular protozoan parasite. It is considerateone of the most common parasite worldwide. The contamination of the parasite is generally occurred via consumptionof infected food or water or, undercooked contaminated meat. Toxoplasma gondii infection may lead to seriousillness when the organism is contracted while pregnancy or when it is reactivated in immune-suppressed persons.Diagnosis of toxoplasmosis in humans is elaborated using various techniques such as detection of anti-Toxoplasmaantibodies, mouse inoculation, histological revelation of tachyzoites in tissue sections or smears of body fluid, but thedetection of Toxoplasma gondii DNA by molecular methods has revolutionized prenatal diagnosis of congenital toxoplasmosisand in immunocompromised patients. In this paper we will discuss the parasite and different methods ofdiagnosis including the usefulness of molecular methods. J Microbiol Infect Dis 2013; 3(2: 93-99Key words: Toxoplamosis, Toxoplasma gondii, diagnosis

Utility of molecular and serodiagnostic tools in cerebral toxoplasmosis with and without tuberculous meningitis in AIDS patients: A study from South India

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Adurthi Sreenivas

2010-01-01

Full Text Available Background: Antemortem diagnosis of cerebral toxoplasmosis, the second most common opportunistic infection (OI in HIV-infected individuals in developing countries is a challenge. Materials and Methods: Toxoplasma gondii (T.gondii -specific serology and nested polymerase chain reaction (nPCR were evaluated in sera and ventricular/lumbar cerebrospinal fluid (CSF of 22 autopsy confirmed cases of cerebral toxoplasmosis with HIV and 17 controls. Frequency of concomitant T.gondii infection was investigated in 17 cases of HIV-associated tuberculous meningitis (TBM. Results: The sensitivity, specificity, and positive and negative predictive values of T. gondii IgG on CSF (ventricular and lumbar and sera was 100% in histology proven cerebral toxoplasmosis (concentrations: 258 ± 50, 231 ± 36, and 646 ± 243 IU/mL, respectively; majority (94% being high avidity type, suggesting reactivation/reinfection. The sensitivity of B1 nPCR was 100% on ventricular CSF, whereas it was only 77% on lumbar CSF. Based on histology, nPCR, and IgG serology, T. gondii co-infection with TBM was observed in 65% (11/17 of cases. Discussion and Conclusion: CSF IgG serology and nPCR are tests with high sensitivity and specificity for the diagnosis of cerebral toxoplasmosis. TBM and cerebral toxoplasmosis can coexist and should be considered in the background of HIV infection in developing countries.

Fatal toxoplasmosis in free-ranging endangered 'Alala from Hawaii

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Work, Thierry M.; Massey, J. Gregory; Rideout, Bruce A.; Gardiner, Chris H.; Ledig, David B.; Kwok, O.C.H.; Dubey, J.P.

2000-01-01

The ‘Alala (Corvus hawaiiensis) is the most endangered corvid in the world, and intensive efforts are being made to reintroduce it to its former native range in Hawaii. We diagnosed Toxoplasma gondii infection in five free-ranging ‘Alala. One ‘Alala, recaptured from the wild because it was underweight and depressed, was treated with diclazuril (10 mg/kg) orally for 10 days. Antibodies were measured before and after treatment by the modified agglutination test (MAT) using whole T. gondii tachyzoites fixed in formalin and mercaptoethanol. The MAT titer decreased four-fold from an initial titer of 1:1,600 with remarkable improvement in physical condition. Lesions of toxoplasmosis also were seen in two partially scavenged carcasses and in a third fresh intact carcass. Toxoplasma gondii was confirmed immunohistochemically by using anti-T. gondii specific serum. The organism was also cultured by bioassay in mice from tissues of one of these birds and the brain of a fifth ‘Alala that did not exhibit lesions. The life cycle of the parasite was experimentally completed in cats. This is the first record of toxoplasmosis in ‘Alala, and the parasite appears to pose a significant threat and management challenge to reintroduction programs for ‘Alala in Hawaii.

Autism Spectrum Disorders May Be Due to Cerebral Toxoplasmosis Associated with Chronic Neuroinflammation Causing Persistent Hypercytokinemia that Resulted in an Increased Lipid Peroxidation, Oxidative Stress, and Depressed Metabolism of Endogenous and Exogenous Substances

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Prandota, Joseph

2010-01-01

Worldwide, approximately 2 billion people are chronically infected with "Toxoplasma gondii" with largely yet unknown consequences. Patients with autism spectrum disorders (ASD) similarly as mice with chronic toxoplasmosis have persistent neuroinflammation, hypercytokinemia with hypermetabolism associated with enhanced lipid peroxidation, and…

Prevalence and Incidence of Toxoplasmosis in HIV-Positive Patients in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Kodym, P.; Hrdá, Š.; Machala, L.; Rozsypal, H.; Staňková, M.; Malý, Marek

2006-01-01

Roč. 53, Suppl. 1 (2006), s. 160-161 ISSN 1066-5234 Source of funding: V - iné verejné zdroje Keywords : toxoplasmosis * HIV infection * prevalence Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.288, year: 2006

Causes of uveitis at a referral center in Saudi Arabia.

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Hamade, Issam Hussein; Elkum, Naser; Tabbara, Khalid F

2009-01-01

The main purpose of this study was to determine the causes of uveitis at the Eye Center in Saudi Arabia. A retrospective review. The causes of uveitis were analyzed according to various patient characteristics. A total of 488 cases were encountered. The age range was 3 to 99 years (mean age: 38 years). The most common causes of uveitis included anterior uveitis 60%, panuveitis 24%, posterior uveitis 11%, and intermediate uveitis 6%. The authors found a high prevalence of acute anterior nongranulomatous uveitis. The most commonly encountered infectious uveitis included herpes virus, tuberculosis, and toxoplasmosis.

Place of Interferon-γ Assay for Diagnosis of Congenital Toxoplasmosis.

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Chapey, Emmanuelle; Wallon, Martine; L'Ollivier, Coralie; Piarroux, Renaud; Peyron, François

2015-12-01

The diagnosis of congenital toxoplasmosis relies mainly on serology. When results are doubtful, pediatricians have difficulties with respect to treatment. We report interferon-γ responses after the stimulation of blood by Toxoplasma gondii antigen in 17 infected infants and 80 infants free of infection. Sensitivity and specificity were 93.75% (95% confidence interval: 67%-99%) and 98.75% (95% confidence interval: 92%-99%), respectively.

Genotyping of samples from German patients with ocular, cerebral and systemic toxoplasmosis reveals a predominance of Toxoplasma gondii type II.

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Herrmann, Daland C; Maksimov, Pavlo; Hotop, Andrea; Groß, Uwe; Däubener, Walter; Liesenfeld, Oliver; Pleyer, Uwe; Conraths, Franz J; Schares, Gereon

2014-10-01

Toxoplasmosis is an important zoonosis transmitted from animals to humans world-wide. In order to determine Toxoplasma gondii genotypes in individuals living in Germany and to compare findings with those in animals, we analysed nine independent and unlinked genetic markers (nSAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico) by PCR-RFLP in 83 archived T. gondii-positive DNA samples from patients with ocular toxoplasmosis (n=35), toxoplasmic encephalitis (n=32), systemic toxoplasmosis after bone-marrow transplantation (n=15) and congenital toxoplasmosis (n=1). In 46 of these 83 samples the presence of T. gondii DNA was confirmed by conventional end-point PCR. Among these, 17 T. gondii-positive samples were typed at all nine loci. The majority (15/17, 88.2%) of these samples were of T. gondii type II (i.e., including both, the Apico type II and Apico type I variants). In addition, in one sample a T. gondii type II/type III allele combination and in another sample a T. gondii genotype displaying type III alleles at all markers was observed. In the remaining 11 samples, in which T. gondii could only be partially typed, exclusively type II (n=10) or type III (n=1) alleles were observed. Results of the present study suggest that the majority of patients in Germany are infected with type II T. gondii regardless of the clinical manifestation of toxoplasmosis. This finding is in accord with the predominance of type II T. gondii in oocysts isolated from cats and in tissues of other intermediate hosts in Germany. Copyright © 2014 Elsevier GmbH. All rights reserved.

[Ophthalmic manifestations of toxoplasmosis in a human immunodeficiency virus-positive patient. Description of a case].

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Hermida Pérez, J A; Bermejo Hernandez, Á; Sobenes Gutierrez, R

2014-03-01

Toxoplasmosis is an infection of worldwide distribution caused by Toxoplasma gondii, and infects a large proportion of the world population. Only under certain circumstances of severe immunosuppression can the parasite reactivate and cause disease. The most common form of presentation of this pathology in patients with positive HIV is the brain abscess. One of the extra-cerebral forms is toxoplasmic chorioretinitis, which could lead to a chronic active form of a slowly progressive retinitis. Diagnosis is made by observing the eye fundus and confirmed by the scarring obtained after specific treatment. We report a case of a patient with diabetes and positive HIV, in whom a toxoplasmic scar injury was detected in the annual retinography follow-up. A conservative therapeutic approach was decided, with regular check-ups for possible detection of disease activation. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

MHC Class I Chain-Related Gene A Polymorphisms and Linkage Disequilibrium with HLA-B and HLA-C Alleles in Ocular Toxoplasmosis

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Ayo, Christiane Maria; Camargo, Ana Vitória da Silveira; Frederico, Fábio Batista; Siqueira, Rubens Camargo; Previato, Mariana; Murata, Fernando Henrique Antunes; Silveira-Carvalho, Aparecida Perpétuo; Barbosa, Amanda Pires; Brandão de Mattos, Cinara de Cássia; de Mattos, Luiz Carlos

2015-01-01

This study investigated whether polymorphisms of the MICA (major histocompatibility complex class I chain-related gene A) gene are associated with eye lesions due to Toxoplasma gondii infection in a group of immunocompetent patients from southeastern Brazil. The study enrolled 297 patients with serological diagnosis of toxoplasmosis. Participants were classified into two distinct groups after conducting fundoscopic exams according to the presence (n = 148) or absence (n = 149) of ocular scars/lesions due to toxoplasmosis. The group of patients with scars/lesions was further subdivided into two groups according to the type of the ocular manifestation observed: primary (n = 120) or recurrent (n = 28). Genotyping of the MICA and HLA alleles was performed by the polymerase chain reaction-sequence specific oligonucleotide technique (PCR-SSO; One Lambda®) and the MICA-129 polymorphism (rs1051792) was identified by nested polymerase chain reaction (PCR-RFLP). Significant associations involving MICA polymorphisms were not found. Although the MICA*002~HLA-B*35 haplotype was associated with increased risk of developing ocular toxoplasmosis (P-value = 0.04; OR = 2.20; 95% CI = 1.05–4.60), and the MICA*008~HLA-C*07 haplotype was associated with protection against the development of manifestations of ocular toxoplasmosis (P-value = 0.009; OR: 0.44; 95% CI: 0.22–0.76), these associations were not statistically significant after adjusting for multiple comparisons. MICA polymorphisms do not appear to influence the development of ocular lesions in patients diagnosed with toxoplasmosis in this study population. PMID:26672749

Acquired neuropathies.

Science.gov (United States)

Lozeron, Pierre; Trocello, Jean-Marc; Kubis, Nathalie

2013-09-01

Acquired neuropathies represent most of the neuropathies encountered in clinical practice. Hundreds of causes have been identified even though up to 41% of patients are still classified as idiopathic (Rajabally and Shah in J Neurol 258:1431-1436, 1). Routine evaluation relies on comprehensive medical history taking, clinical examination, nerve conduction studies and laboratory tests. Other investigations such as nerve biopsy or nerve or muscle imaging are performed in specific settings. This review focuses on recent advances in acquired neuropathies.

Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data

DEFF Research Database (Denmark)

Thiébaut, Rodolphe; Leproust, Sandy; Chêne, Geneviève

2007-01-01

BACKGROUND: Despite three decades of prenatal screening for congenital toxoplasmosis in some European countries, uncertainty remains about the effectiveness of prenatal treatment. METHODS: We did a systematic review of cohort studies based on universal screening for congenital toxoplasmosis. We did...... a meta-analysis using individual patients' data to assess the effect of timing and type of prenatal treatment on mother-to-child transmission of infection and clinical manifestations before age 1 year. Analyses were adjusted for gestational age at maternal seroconversion and other covariates. FINDINGS......: We included 26 cohorts in the review. In 1438 treated mothers identified by prenatal screening, we found weak evidence that treatment started within 3 weeks of seroconversion reduced mother-to-child transmission compared with treatment started after 8 or more weeks (adjusted odds ratio [OR] 0.48, 95...

Cardiac toxoplasmosis after heart transplantation diagnosed by endomyocardial biopsy.

Science.gov (United States)

Petty, L A; Qamar, S; Ananthanarayanan, V; Husain, A N; Murks, C; Potter, L; Kim, G; Pursell, K; Fedson, S

2015-10-01

We describe a case of cardiac toxoplasmosis diagnosed by routine endomyocardial biopsy in a patient with trimethoprim-sulfamethoxazole (TMP-SMX) intolerance on atovaquone prophylaxis. Data are not available on the efficacy of atovaquone as Toxoplasma gondii prophylaxis after heart transplantation. In heart transplant patients in whom TMP-SMX is not an option, other strategies may be considered, including the addition of pyrimethamine to atovaquone. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Testicular toxoplasmosis in a 26-year-old immunocompetent man.

Science.gov (United States)

Wong, Vincent; Amarasekera, Channa; Kundu, Shilajit

2018-06-04

Testicular toxoplasmosis is a very rare presentation of Toxoplasma gondii A 26-year-old immunocompetent man presented to us with right testicular pain and a right epididymal mass. Ultrasound was concerning for malignancy and a radical orchiectomy was performed. Surgical pathology revealed chronic granulomatous inflammation which stained positive for T. gondii . © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Toxoplasmosis as a public health issue in Serbia = Toxoplasmose como assunto de saúde pública na Sérvia

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Djurkovic-Djakovic, Olgica

2010-01-01

Conclusions: It is expected that the recent appointment of the National Reference Laboratory for Toxoplasmosis as the focal point for the collection of data from the primary level, will provide the means for accurate assessment of the measure of the problem, which is a prerequisite of an evidence-based nation-wide prevention program. In the meantime, health education of all pregnant women, focused at risk factors of major local significance, is advocated as a sound and financially sustainable option to reduce congenital toxoplasmosis

Molecular Characterization of Streptococcus agalactiae Causing Community- and Hospital-acquired Infections in Shanghai, China

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Haoqin Jiang

2016-08-01

Full Text Available Streptococcus agalactiae, a colonizing agent in pregnant women and the main cause of neonatal sepsis and meningitis, has been increasingly associated with invasive disease in nonpregnant adults. We collected a total of 87 non-repetitive S. agalactiae isolates causing community-acquired (CA and hospital-acquired (HA infections in nonpregnant adults from a teaching hospital in Shanghai between 2009 and 2013. We identified and characterized their antibiotic resistance, sequence type (ST, serotype, virulence, and biofilm formation. The most frequent STs were ST19 (29.9%, ST23 (16.1%, ST12 (13.8%, and ST1 (12.6%. ST19 had significantly different distributions between CA- and HA-group B Streptococci (GBS isolates. The most frequent serotypes were III (32.2%, Ia (26.4%, V (14.9%, Ib (13.8%, and II (5.7%. Serotype III/ST19 was significantly associated with levofloxacin resistance in all isoates. The HA-GBS multidrug resistant rate was much higher than that of CA-GBS. Virulence genes pavA, cfb were found in all isolates. Strong correlations exist between serotype Ib (CA and HA and surface protein genes spb1 and bac, serotype III (HA and surface protein gene cps and GBS pilus cluster. The serotype, epidemic clone, PFGE-based genotype, and virulence gene are closely related between CA-GBS and HA-GBS, and certain serotypes and clone types were significantly associated with antibiotic resistance. However, CA-GBS and HA-GBS still had significant differences in their distribution of clone types, antibiotic resistance, and specific virulence genes, which may provide a basis for infection control.

Evaluation of Propranolol Effect on Experimental Acute and Chronic Toxoplasmosis Using Quantitative PCR

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Montazeri, Mahbobeh; Ebrahimzadeh, Mohammad Ali; Ahmadpour, Ehsan; Sharif, Mehdi; Sarvi, Shahabeddin

2016-01-01

Current therapies against toxoplasmosis are limited, and drugs have significant side effects and low efficacies. We evaluated the potential anti-Toxoplasma activity of propranolol at a dose of 2 or 3 mg/kg of body weight/day in vivo in the acute and chronic phases. Propranolol as a cell membrane-stabilizing agent is a suitable drug for inhibiting the entrance of Toxoplasma gondii tachyzoites into cells. The acute-phase assay was performed using propranolol, pyrimethamine, and propranolol plus pyrimethamine before (pretreatment) and after (posttreatment) intraperitoneal challenge with 1 × 103 tachyzoites of the virulent T. gondii strain RH in BALB/c mice. Also, in the chronic phase, treatment was performed 12 h before intraperitoneal challenge with 1 × 106 tachyzoites of the virulent strain RH of T. gondii in rats. One week (in the acute phase) and 2 months (in the chronic phase) after postinfection, tissues were isolated and DNA was extracted. Subsequently, parasite load was calculated using quantitative PCR (qPCR). In the acute phase, in both groups, significant anti-Toxoplasma activity was observed using propranolol (P toxoplasmosis. Also, propranolol combined with pyrimethamine reduced the parasite load as well as significantly increased survival of mice in the pretreatment group. In the chronic phase, anti-Toxoplasma activity and decreased parasite load in tissues were observed with propranolol. In conclusion, the presented results demonstrate that propranolol, as an orally available drug, is effective at low doses against acute and latent murine toxoplasmosis, and the efficiency of the drug is increased when it is used in combination therapy with pyrimethamine. PMID:27645234

Immune responses of dendritic cells after acquiring antigen from apoptotic hepatocholangioma cells caused by γ-ray

International Nuclear Information System (INIS)

Wu Gang; Gu Hongguang; Han Benli; Pei Xuetao

2002-01-01

Objective: To investigate the induction of cytotoxic T lymphocytes (CTLs) in antitumor responsiveness and therapeutic effects after dendritic cells (DCs) acquired antigen from apoptotic hepatocholangioma cells. Methods: DCs from blood mononuclear cells that maintain the characteristics of immaturity-anti-gen-capturing and-processing capacity were established in vitro by using granulocyte/macrophage colony-stimulating factor (GM-CSF) and interleukin-4. Then, apoptosis in hepatocholangioma cells was induced with γ-radiation. The experimental groups included (1) co-culture of DCs, and apoptotic cancer cells and T cells; (2) co-culture of DCs necrotic cancer cells and T cells; (3) co-culture of DCs-cultured cancer cell and T cells. These cells were co-cultured for 7 days. DCs and T cell were enriched separately. Finally, antitumor response test was carried out. Results: These cells had typical dendritic morphology, expressed high levels of CD1a, B7 and acquired antigen from apoptotic cells caused by γ-rays and induced an increased T cell-stimulatory capacity in MLR. Conclusions: DCs obtained from blood mononuclear cells using GM-CSF and IL-4 and DCs can efficiently present antigen driven from apoptotic cells caused by γ-rays and induce T cells increasing obviously. It can probably become an effective approach of DC transduction with antigen

Detection of CTX-M-15 beta-lactamases in Enterobacteriaceae causing hospital- and community-acquired urinary tract infections as early as 2004, in Dar es Salaam, Tanzania.

Science.gov (United States)

Manyahi, Joel; Moyo, Sabrina J; Tellevik, Marit Gjerde; Ndugulile, Faustine; Urassa, Willy; Blomberg, Bjørn; Langeland, Nina

2017-04-17

The spread of Extended Spectrum β-lactamases (ESBLs) among Enterobacteriaceae and other Gram-Negative pathogens in the community and hospitals represents a major challenge to combat infections. We conducted a study to assess the prevalence and genetic makeup of ESBL-type resistance in bacterial isolates causing community- and hospital-acquired urinary tract infections. A total of 172 isolates of Enterobacteriaceae were collected in Dar es Salaam, Tanzania, from patients who met criteria of community and hospital-acquired urinary tract infections. We used E-test ESBL strips to test for ESBL-phenotype and PCR and sequencing for detection of ESBL genes. Overall 23.8% (41/172) of all isolates were ESBL-producers. ESBL-producers were more frequently isolated from hospital-acquired infections (32%, 27/84 than from community-acquired infections (16%, 14/88, p Enterobacteriaceae causing both hospital- and community-acquired infections in Tanzania.

Seroprevalence of toxoplasmosis in voluntary blood donors of Puducherry and surrounding districts of Tamil Nadu.

Science.gov (United States)

Stephen, Selvaraj; Pradeep, Jothimani; Anitharaj, Velmurugan; Janarthanam, Venkatraman

2017-12-01

Our objective is to study the seroprevalence of toxoplasmosis in the voluntary blood donors of Puducherry and surrounding districts of Tamil Nadu. A total of 275 healthy blood donors were screened for the presence of IgM and IgG antibodies to Toxoplasma gondii by ELISA test. Donor samples positive for IgM and/or IgG antibodies to T. gondii were subjected to IgG avidity ELISA. While, 54 out of 275 donors had IgG antibodies (19.66%), only one donor had IgM (0.36%) along with IgG. Among 54 IgG positive donors, only two had low avidity (3.7%), indicating recent exposure to the protozoa. Feasibility and cost effectiveness studies should be conducted throughout India to decide regarding screening of blood donors for toxoplasmosis.

ALOX12 in Human Toxoplasmosis

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Witola, William H.; Liu, Susan Ruosu; Montpetit, Alexandre; Welti, Ruth; Hypolite, Magali; Roth, Mary; Zhou, Ying; Mui, Ernest; Cesbron-Delauw, Marie-France; Fournie, Gilbert J.; Cavailles, Pierre; Bisanz, Cordelia; Boyer, Kenneth; Withers, Shawn; Noble, A. Gwendolyn; Swisher, Charles N.; Heydemann, Peter T.; Rabiah, Peter; Muench, Stephen P.

2014-01-01

ALOX12 is a gene encoding arachidonate 12-lipoxygenase (12-LOX), a member of a nonheme lipoxygenase family of dioxygenases. ALOX12 catalyzes the addition of oxygen to arachidonic acid, producing 12-hydroperoxyeicosatetraenoic acid (12-HPETE), which can be reduced to the eicosanoid 12-HETE (12-hydroxyeicosatetraenoic acid). 12-HETE acts in diverse cellular processes, including catecholamine synthesis, vasoconstriction, neuronal function, and inflammation. Consistent with effects on these fundamental mechanisms, allelic variants of ALOX12 are associated with diseases including schizophrenia, atherosclerosis, and cancers, but the mechanisms have not been defined. Toxoplasma gondii is an apicomplexan parasite that causes morbidity and mortality and stimulates an innate and adaptive immune inflammatory reaction. Recently, it has been shown that a gene region known as Toxo1 is critical for susceptibility or resistance to T. gondii infection in rats. An orthologous gene region with ALOX12 centromeric is also present in humans. Here we report that the human ALOX12 gene has susceptibility alleles for human congenital toxoplasmosis (rs6502997 [P, <0.000309], rs312462 [P, <0.028499], rs6502998 [P, <0.029794], and rs434473 [P, <0.038516]). A human monocytic cell line was genetically engineered using lentivirus RNA interference to knock down ALOX12. In ALOX12 knockdown cells, ALOX12 RNA expression decreased and levels of the ALOX12 substrate, arachidonic acid, increased. ALOX12 knockdown attenuated the progression of T. gondii infection and resulted in greater parasite burdens but decreased consequent late cell death of the human monocytic cell line. These findings suggest that ALOX12 influences host responses to T. gondii infection in human cells. ALOX12 has been shown in other studies to be important in numerous diseases. Here we demonstrate the critical role ALOX12 plays in T. gondii infection in humans. PMID:24686056

Prevalence of toxoplasmosis and related risk factors among humans referred to main laboratories of Urmia city, North West of Iran, 2013.

Science.gov (United States)

Sadaghian, Mohammad; Amani, Sasan; Jafari, Rasool

2016-06-01

Toxoplasmosis is mostly asymptomatic infection in immunocompetent individuals while it can cause a severe infection in human fetus during pregnancy and immunocompromised patients. This study aimed to determine the prevalence of anti-Toxoplasma IgM and IgG seropositivity and potential risk factors of the infection in humans referred to Urmia City main diagnostic laboratories, Urmia, Iran. Totally 195 blood samples were collected from the individuals referred to main diagnostic laboratories of Urmia City, 2013. Serum concentration of anti-Toxoplasma IgG and IgM were determined using ELISA method. Demographic variables of the participants were collected by interviewing, which are including sex, age, occupation, educational and residential status, eating undercooked meat, consumption of raw vegetable and the method of washing raw vegetables. None of all 200 serum sample were anti-Toxoplasma IgM positive, but different concentrations of anti-Toxoplasma IgG were observed in 88 (45.12 %) of samples. The significant higher rate of anti-Toxoplasma IgG seropositivity were observed in people with soil related jobs (P = 0.005, OR = 2.266; 95 % CI 1.260, 4.078) and history of eating raw vegetables at restaurant (P = 0.036, OR = 1.985; 95 % CI 0.991, 3.978). Also anti-Toxoplasma IgG concentration mean was significantly higher in people who were commonly eaten raw vegetable at restaurants (P restaurants increases the risk of acquiring the infection.

AKT-mediated enhanced aerobic glycolysis causes acquired radioresistance by human tumor cells

International Nuclear Information System (INIS)

Shimura, Tsutomu; Noma, Naoto; Sano, Yui; Ochiai, Yasushi; Oikawa, Toshiyuki; Fukumoto, Manabu; Kunugita, Naoki

2014-01-01

Background and purpose: Cellular radioresistance is a major impediment to effective radiotherapy. Here, we demonstrated that long-term exposure to fractionated radiation conferred acquired radioresistance to tumor cells due to AKT-mediated enhanced aerobic glycolysis. Material and methods: Two human tumor cell lines with acquired radioresistance were established by long-term exposure to fractionated radiation with 0.5 Gy of X-rays. Glucose uptake was inhibited using 2-deoxy-D-glucose, a non-metabolizable glucose analog. Aerobic glycolysis was assessed by measuring lactate concentrations. Cells were then used for assays of ROS generation, survival, and cell death as assessed by annexin V staining. Results: Enhanced aerobic glycolysis was shown by increased glucose transporter Glut1 expression and a high lactate production rate in acquired radioresistant cells compared with parental cells. Inhibiting the AKT pathway using the AKT inhibitor API-2 abrogated these phenomena. Moreover, we found that inhibiting glycolysis with 2-deoxy-D-glucose suppressed acquired tumor cell radioresistance. Conclusions: Long-term fractionated radiation confers acquired radioresistance to tumor cells by AKT-mediated alterations in their glucose metabolic pathway. Thus, tumor cell metabolic pathway is an attractive target to eliminate radioresistant cells and improve radiotherapy efficacy

Seroepidemiology of Toxoplasmosis among People Having Close Contact with Animals.

Science.gov (United States)

Brandon-Mong, Guo-Jie; Che Mat Seri, Nurul Asma Anati; Sharma, Reuben Sunil-Kumar; Andiappan, Hemah; Tan, Tian-Chye; Lim, Yvonne Ai-Lian; Nissapatorn, Veeranoot

2015-01-01

A cross-sectional study was conducted to determine the seroepidemiology of Toxoplasma infection and its risk association among people having close contact with animals. A total of 312 blood samples were collected from veterinary personnel (veterinarian, technicians, and students) and pet owners from veterinary clinics and hospitals in the area of Klang Valley, Malaysia. About 4 cc of blood samples drawn from agreed participants were processed for measurement of anti-Toxoplasma IgG and IgM antibodies as well as avidity test of Toxoplasma IgG by ELISA I, II, and III kits. Meanwhile, the demographic profiles and possible risk factors of these participants were also recorded in the standardized data collection sheets. Overall seroprevalence of toxoplasmosis was observed in 62 (19.9%) participants being 7 (18.4%) in veterinarians, 15 (33.3%) in veterinary technicians, 29 (14.9%) in veterinary students, and 11 (31.4%) in pet owners. Of 19.9% Toxoplasma seropositive samples, 18.3% was positive for IgG antibody, 1.0% for IgM antibody, and 0.6% for both IgG and IgM antibodies. Of three different IgG avidity ELISA kits, ELISA III showed high avidity in all five seropositive samples (IgM and IgG/IgM antibodies) indicating chronic Toxoplasma infection which is consistent with no evidence of clinical toxoplasmosis diagnosed during the time of this study. Univariate analysis showed that age group, gender, study population, gardening, task performance, and working duration were significantly associated with Toxoplasma seropositivity. Further analysis by multivariate analysis using logistic regression showed that age group of ≥30 years old (OR = 0.34, 95% CI = 0.18-0.63, p = 0.001) and working or study duration of >10 years having close contact with animals (OR = 5.07, 95% CI = 1.80-14.24, p = 0.002) were identified as significant risks for Toxoplasma infection. Based on the results obtained, a comprehensive Toxoplasma screening and health

Acquired factor VIII inhibitor syndrome: A rare cause of hematuria

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Muthuvel Seral Kannan

2015-01-01

Full Text Available A 50-year-old woman presented with gross hematuria for 1 month. Clinical examinations, laboratory investigations, ultrasound and contrast computed tomography were normal, except anemia. Cystoscopy revealed bloody efflux from the right side. Retrograde pyelogram showed filling defect in the renal pelvis and biopsy was inconclusive. Renal angiogram was normal. She developed ecchymosis on the right thigh and arm with elevated activated partial thromboplastin time. The partial thromboplastin time correction study and Bethesda study confirmed the presence of acquired factor VIII inhibitor (acquired hemophilia. With flexible ureterorenoscopy, the mass in the renal pelvis was removed and its histopathology revealed clotted blood. The patient was subsequently managed with steroids and Factor eight inhibitor bypass activity.

Incidence, presentation and outcome of toxoplasmosis in HIV infected in the combination antiretroviral therapy era

DEFF Research Database (Denmark)

Martin-Iguacel, Raquel; Ahlstrom, Magnus Glindvad; Touma, Madeleine

2017-01-01

Background: HIV-associated incidence and prognosis of cerebral toxoplasmosis (CTX) is not well established during later years. Methods: From the Danish HIV Cohort Study, we identified 6325 HIV-infected individuals. We assessed incidence, mortality, predictive and prognostic factors of CTX during...

Clinical and radiological characterization of the pulmonary commitment for acute toxoplasmosis disseminated in nine immunocompetent patients

International Nuclear Information System (INIS)

Salinas, Jorge E; Pino, Luis Eduardo

2008-01-01

The acute toxoplasmosis in the immunocompetent individual generally has a benign and autoresolutive course. However, in patient coming from wild area severe cases of visceral commitment, the most frequent in them, the pulmonary commitment has been reported. The clinical and radiological description of nine individuals members of the military forces of Colombia, with acute toxoplasmosis and pulmonary commitment was carried. 55% of the cases presented dysnea functional class II/IV; 33% functional class III/IV and only 1/9 patients presented functional class IV/IV. The most common radiological image was the uni focal or multifocal consolidation pulmonary (66%), and in smaller frequency the presence of having infiltrated reticular, reticulo nodular and pleural effusion. The entirety of the patients evolved in satisfactory form, two of them with support with noninvasive ventilation.

Diagnosis of toxoplasmosis in pregnancy. Evaluation of latex-protein complexes by immnunoagglutination.

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Peretti, Leandro E; Gonzalez, Verónica D G; Marcipar, Iván S; Gugliotta, Luis M

2017-07-01

The aim of this work was to obtain a reagent based on latex particles for ruling out acute toxoplasmosis in pregnant women by immunoagglutination (IA). Latex-protein complexes (LPC) were previously synthesized coupling the recombinant protein of Toxoplasma gondii P22Ag and the homogenate of the parasite to latex particles with different size, chemical functionality and charge density. LPC were tested in IA assays against a panel of 72 pregnant women serum samples. Results were analysed through receiver operating characteristic curves, determining area under the curve (AUC), sensitivity, specificity positive and negative predictive values (PPV and NPV, respectively). It was observed that the antigenicity of proteins was not affected during sensitization by either physical adsorption or covalent coupling. The best results in the sense of maximizing discrimination of low avidity sera from chronic ones were observed for the IA test based on latex particles with carboxyl functionality and the recombinant P22Ag, obtaining an AUC of 0·94, a sensitivity of 100% and a NPV of 100%. In this way, the proposed test could be useful for the toxoplasmosis diagnosis in pregnant women, with the advantages of being cheap, rapid and easy to be implemented.

Waterborne toxoplasmosis investigated and analyzed under hydrogeological assessment: new data and perspectives for further research

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We present a set of data on human and chicken Toxoplasma gondii seroprevalence that was investigated and analyzed in light of groundwater vulnerability information in an area of endemic waterborne toxoplasmosis in Brazil. Hydrogeological assessment was undertaken to conduct water collection from wel...

The potential risk of toxoplasmosis for traffic accidents: A systematic review and meta-analysis.

Science.gov (United States)

Gohardehi, Shaban; Sharif, Mehdi; Sarvi, Shahabeddin; Moosazadeh, Mahmood; Alizadeh-Navaei, Reza; Hosseini, Seyed Abdollah; Amouei, Afsaneh; Pagheh, Abdolsattar; Sadeghi, Mitra; Daryani, Ahmad

2018-06-12

Toxoplasmosis is a prevalent infectious disease. Although most people infected by Toxoplasma gondii are asymptomatic, evidence has suggested that this disease might affect some aspects of a host's behavior and associate with schizophrenia, suicide attempt, changes in various aspects of personality, and poor neurocognitive performance. These associations may play roles in increasing the risk of a number of incidents, such as traffic accidents, among infected people. In this regard, this study aimed to provide summary estimates for the available data on the potential risk of toxoplasmosis for traffic accidents. To this end, using a number of search terms, i.e. toxoplasmosis, Toxoplasma gondii, traffic accident, road accident, car accident, crash, and prevalence, literature searches (up to October 1, 2017) were carried out via 6 databases. The meta-analysis was conducted using the StatsDirect statistical software and a P-value less than 0.05 was regarded as significant in all statistical analyses. Out of 1841 identified studies, 9 studies were finally considered eligible for carrying out this systematic review. Reviewing results of these studies indicated that 5 out of 9 studies reported a significant relationship between Toxoplasma gondii and traffic accidents. Additionally, data related to gender showed significant differences between infected and control men and women. Considering age, reviewing the results of these studies revealed a significant difference between the infected people and the Toxoplasma-negative subjects under 45 years of age. However, no significant difference was found between the two groups aged 45 or older. Given these results, it can be concluded that Toxoplasma gondii significantly increases the risk of having traffic accidents. Copyright © 2018 Elsevier Inc. All rights reserved.

Toxoplasmosis congénita: aspectos clínicos y epidemiológicos de la infección durante el embarazo

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Fernando Rosso; Alejandro Agudelo; Ángela Isaza; José Gilberto Montoya

2007-01-01

Se presenta una revisión actualizada sobre la toxoplasmosis durante el embarazo y de su consecuencia la toxoplasmosis congénita. Se pretende ilustrar a los profesionales de la salud con los diferentes aspectos tanto epidemiológicos como clínicos concernientes a esta enfermedad. Se revisan conceptos actuales de la parasitología y de la epidemiología de la transmisión materno-fetal, así como la presentación clínica de la infección perinatal. Se discuten nuevos adelantos en el diagnóstico y su i...

Observational study to assess pregnant women’s knowledge and behaviour to prevent toxoplasmosis, listeriosis and cytomegalovirus.

NARCIS (Netherlands)

Pereboom, M.T.R.; Manniën, J.; Spelten, E.R.; Schellevis, F.G.; Hutton, E.K.

2013-01-01

Background: Toxoplasmosis, listeriosis and cytomegalovirus (CMV) can negatively affect pregnancy outcomes, but can be prevented by simple precautions of pregnant women. Literature suggests that pregnant women are not always adequately informed by their care provider about preventable infectious

Phenotypic and molecular characterization of Klebsiella spp. isolates causing community-acquired infections

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U. Garza-Ramos

2018-05-01

Full Text Available Klebsiella spp. isolates from community-acquired infections were characterized. A total of 39 Klebsiella spp. isolates were obtained from outpatients at four rural hospitals in Mexico (2013–2014. The biochemical tests identified all as being K. pneumoniae. The molecular multiplex-PCR test identified 36 (92.4% K. pneumoniae isolates and one (2.5% K. variicola isolate, and phylogenetic analysis of the rpoB gene identified two isolates (5.1% belonging to K. quasipneumoniae subsp. quasipneumoniae and K. quasivariicola. The last one was confirmed by phylogenetic analysis of six-loci concatenated genes. Mostly the isolates were multidrug resistant; however, a minority were extended-spectrum β-lactamase producing (10.2%. The extended-spectrum β-lactamase CTX-M-15 gene was identified in these isolates. Analysis of biofilm production and the hypermucoviscosity phenotype showed a total of 35 (92.3% and seven (17.9% of the isolates were positive for these phenotypes respectively. The K2 (4/39, 10.2%, K5 (2/39, 5.1% and K54 (1/39, 2.5% serotypes were identified in seven (17.9% of the isolates, and only 28.5% (2/7 hypermucoviscous isolates were positive for the K2 and K5 serotypes. In general, the sequence type (ST analysis and phylogenetic analysis of seven multilocus sequence typing loci were heterogeneous; however, ST29 was the most prevalent ST in the analysed isolates, accounting for 19% (4/21 of the total isolates. Two of the four ST29 isolates had the hypermucoviscosity phenotype. The virulence factors for fimbriae were the most prevalent, followed by siderophores. Community-acquired infections are caused by various species from Klebsiella genus, with different profiles of antibiotic resistance and heterogeneous virulence factors. Keywords: Antimicrobial susceptibility, Bacterial resistance, Cephalosporin resistance, Community infection, ESBL, Hypermucoviscosity

Aetiological considerations of acquired aplastic anaemia

International Nuclear Information System (INIS)

Malik, S.; Sarwar, I.; Mehmood, T.; Naz, F.

2009-01-01

Acquired aplastic anaemia is one of the important causes of pancytopenia. This study was conducted to observe the mode of presentation of acquired aplastic anaemia and to find out its possible etiological factors. Methods: It is a hospital based descriptive study of 100 patients of acquired aplastic anaemia. Results: Out of 100 patients 60 were male and 40 female. Majority (44%) of the patients were between 12 - 20 years of age. Patient presented with variable symptoms majority (40%) with fever. Most of the patients had haemoglobin levels between 4 - 6 gm/dl. (53%). Seventy percent of the cases had no obvious cause, while in 30% some known causative factors were found. Chloramphenicol was found to be the most common causative drug. Mortality was 35%. Thirty patients were partially treated and 15 were lost to follow up. Twenty patients showed improvement with treatment. Conclusions: Acquired aplastic anaemia is common among males and more prevalent in younger age group. It is idiopathic in 70% cases while 30% had some cause. It has very high mortality. Doctors need to keep in mind this fatal condition in patients presenting with anaemia and should properly investigate before prescribing antibiotics and haematinics. (author)

[Good's syndrome and congenital toxoplasmosis due to maternal reactivation during pregnancy].

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Tahiri, J; Fouyssac, F; Morel, O; Maatouk, A

2017-05-01

Good syndrome is a rare condition in which thymoma is associated with hypogammaglobulinemia. It is characterized by an increased susceptibility to infections. We report a woman with Good's syndrome diagnosed after severe congenital toxoplasmosis in her daughter, even though she was immunized against this infection during pregnancy. This presentation is very unusual by its early diagnosis and to our knowledge is the first report of parasitic infection in this syndrome. Copyright © 2016. Published by Elsevier SAS.

Toxoplasmosis in dogs: First report of Toxoplasma gondii infection in any animal species in Angola

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Despite the worldwide importance of zoonotic parasite Toxoplasma gondii nothing is known of toxoplasmosis in animals in Angola. The present study aimed at estimating the seroprevalence and also assessing correlates of T. gondii infection in pet dogs from Luanda, Angola. Dogs (n = 103) brought to a v...

Detección de toxoplasmosis congénita en líquido amniótico humano mediante la técnica de nested-pcr

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A. Hortúa

2000-07-01

Full Text Available La toxoplasmosis es provocada por el parasite intracelular obligado Toxoplasma gondii,de la familia Toxoplasmidae (Flores, 1991. Este parasite puede ser asintomático en adultos con un sistema inmune normal, pero puede ser de gran trascendencia en el feto en gestación y en pacientes con SIDA o deficiencia en el sistema inmune (Montoya, 1996. La presencia de anticuerpos antitoxoplasma indica únicamente que la persona se infecto con el microorganismo en un momento dado y no que haya oeste desarrollando la toxoplasmosis necesariamente, pero un resultado positivo indica que el individuo está en riesgo de desarrollar la enfermedad (Perea, 1983. \\ Si la infección se produce durante el embarazo, existe la posibilidad que la toxoplasmosis sea transmitida al feto ocasionando aborto espontaneo, prematuridad o enfermedades severas en el feto, tales como: hidrocefalia y calcificaciones inn-ace- i rebrales (Picazo, 1994. En la mayoría de los casos el diagnóstico biológico de la toxoplasmosis congénita se basa en métodos serológicos indirectos; sin embargo, en los últimos años los diversos estudios realizados en Biología Molecular permitieron utilizar la Técnica de Reacción en Cadena de la Polimerasa (PCR para el diagnóstico de la enfermedad (Hohlfeld, 1994. Los primeros estudios en PCR fueron dirigidos a la amplificación de la secuencia repetitiva del gen B1 de Toxoplasma gondii en líquido amniótico de mujeres infectadas (Grover, 1990. La prueba de PCR en liquido amniótico es definitivamente mas sensible que otras técnicas convencionales usadas, ya que estas presentan dificultad en establecer un diagnóstico segura y oportuno, por esto se ha implementando la técnica de PCR en la detección de la toxoplasmosis, aportando un progreso indiscutible en aquellos casos donde los exámenes clínicos y serológicos presentan limitaciones. También disminuye el tiempo de análisis de las muestras arrojando resultados en un período máximo de 24

Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study.

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Mario Cortina-Borja

2010-10-01

Full Text Available The effectiveness of prenatal treatment to prevent serious neurological sequelae (SNSD of congenital toxoplasmosis is not known.Congenital toxoplasmosis was prospectively identified by universal prenatal or neonatal screening in 14 European centres and children were followed for a median of 4 years. We evaluated determinants of postnatal death or SNSD defined by one or more of functional neurological abnormalities, severe bilateral visual impairment, or pregnancy termination for confirmed congenital toxoplasmosis. Two-thirds of the cohort received prenatal treatment (189/293; 65%. 23/293 (8% fetuses developed SNSD of which nine were pregnancy terminations. Prenatal treatment reduced the risk of SNSD. The odds ratio for prenatal treatment, adjusted for gestational age at maternal seroconversion, was 0.24 (95% Bayesian credible intervals 0.07-0.71. This effect was robust to most sensitivity analyses. The number of infected fetuses needed to be treated to prevent one case of SNSD was three (95% Bayesian credible intervals 2-15 after maternal seroconversion at 10 weeks, and 18 (9-75 at 30 weeks of gestation. Pyrimethamine-sulphonamide treatment did not reduce SNSD compared with spiramycin alone (adjusted odds ratio 0.78, 0.21-2.95. The proportion of live-born infants with intracranial lesions detected postnatally who developed SNSD was 31.0% (17.0%-38.1%.The finding that prenatal treatment reduced the risk of SNSD in infected fetuses should be interpreted with caution because of the low number of SNSD cases and uncertainty about the timing of maternal seroconversion. As these are observational data, policy decisions about screening require further evidence from a randomized trial of prenatal screening and from cost-effectiveness analyses that take into account the incidence and prevalence of maternal infection. Please see later in the article for the Editors' Summary.

Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study.

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Cortina-Borja, Mario; Tan, Hooi Kuan; Wallon, Martine; Paul, Malgorzata; Prusa, Andrea; Buffolano, Wilma; Malm, Gunilla; Salt, Alison; Freeman, Katherine; Petersen, Eskild; Gilbert, Ruth E

2010-10-12

The effectiveness of prenatal treatment to prevent serious neurological sequelae (SNSD) of congenital toxoplasmosis is not known. Congenital toxoplasmosis was prospectively identified by universal prenatal or neonatal screening in 14 European centres and children were followed for a median of 4 years. We evaluated determinants of postnatal death or SNSD defined by one or more of functional neurological abnormalities, severe bilateral visual impairment, or pregnancy termination for confirmed congenital toxoplasmosis. Two-thirds of the cohort received prenatal treatment (189/293; 65%). 23/293 (8%) fetuses developed SNSD of which nine were pregnancy terminations. Prenatal treatment reduced the risk of SNSD. The odds ratio for prenatal treatment, adjusted for gestational age at maternal seroconversion, was 0.24 (95% Bayesian credible intervals 0.07-0.71). This effect was robust to most sensitivity analyses. The number of infected fetuses needed to be treated to prevent one case of SNSD was three (95% Bayesian credible intervals 2-15) after maternal seroconversion at 10 weeks, and 18 (9-75) at 30 weeks of gestation. Pyrimethamine-sulphonamide treatment did not reduce SNSD compared with spiramycin alone (adjusted odds ratio 0.78, 0.21-2.95). The proportion of live-born infants with intracranial lesions detected postnatally who developed SNSD was 31.0% (17.0%-38.1%). The finding that prenatal treatment reduced the risk of SNSD in infected fetuses should be interpreted with caution because of the low number of SNSD cases and uncertainty about the timing of maternal seroconversion. As these are observational data, policy decisions about screening require further evidence from a randomized trial of prenatal screening and from cost-effectiveness analyses that take into account the incidence and prevalence of maternal infection. Please see later in the article for the Editors' Summary.

Prevalencia de los factores de riesgo para toxoplasmosis congénita en maternas

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Yolanda Torres de Galvis

2001-04-01

Full Text Available

La toxoplasmosis a pesar de no ser una causa frecuente de infección en la gestante, sí constituye un factor de riesgo para el binomio madre-hijo. En nuestro medio la incapacidad para hacer un diagnóstico prenatal precoz y específico es muy grande debido a los costos; por lo tanto, la estrategia para disminuir este problema es principalmente la prevención. La toxoplasmosis congénita adquiere importancia cuando ocurre como primoinfección en la mujer embarazada, ocasionando anormalidades fetales. Los principales factores de riesgo están asociados a la convivencia con felinos.
En la ciudad de Medellín se han desarrollado dos estudios sobre el
tema: uno en el sector oficial con prevalencia de infección en gestantes del 38% (610 mujeres, y el segundo una encuesta en Susalud con 200 mujeres maternas en el que se encontró que el 86% de ellas desconocían la enfermedad, un 14.5% convivían con gatos, y el 27.6% comían carne mal cocida.

Conocimientos sobre toxoplasmosis de las mujeres en edad fértil de un consultorio médico en Trinidad

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Nicel Rusindo Hernández

Full Text Available Introducción: la toxoplasmosis es una enfermedad de etiología parasitaria causada por el protozoo Toxoplasma gondii, esta entidad resulta de interés para la salud pública debido al riesgo de transmisión del parásito de la madre al feto durante el embarazo. Objetivo: explorar el nivel de conocimientos sobre la toxoplasmosis que poseen las mujeres en edad fértil del Consultorio Médico de la Familia N 0 21 del Policlínico II en Trinidad. Sancti Spíritus. Métodos: se realizó un estudio descriptivo de corte transversal que consistió en la aplicación de un cuestionario sobre el tema a las 119 mujeres en edad fértil del Consultorio antes mencionado, de ellas 15 eran gestantes (12,61 % y 104 no gestantes (87,39 %. Resultados: se determinó un alto porcentaje de mujeres evaluadas de no satisfactorio. Una cifra considerable de encuestadas relacionó a los gatos con la enfermedad. Conclusiones: El conocimiento de las mujeres encuestadas sobre la toxoplasmosis es insuficiente, lo cual dicta la necesidad de una intervención educativa sobre el tema con vista a prevenir los efectos negativos de la misma.

Vaccination with a DNA vaccine encoding Toxoplasma gondii ROP54 induces protective immunity against toxoplasmosis in mice.

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Yang, Wen-Bin; Zhou, Dong-Hui; Zou, Yang; Chen, Kai; Liu, Qing; Wang, Jin-Lei; Zhu, Xing-Quan; Zhao, Guang-Hui

2017-12-01

Toxoplasma gondii is an obligatory intracellular protozoan, which infects most of the warm-blooded animals, causing serious public health problems and enormous economic losses worldwide. The rhoptry effector protein 54 (ROP54) has been indicated as a virulence factor that promotes Toxoplasma infection by modulating GBP2 loading onto parasite-containing vacuoles, which can modulate some aspects of the host immune response. In order to evaluate the immuno-protective value of ROP54, we constructed a eukaryotic recombinant plasmid expressing T. gondii ROP54 and intramuscularly immunized Kunming mice with this recombinant plasmid against acute and chronic toxoplasmosis. All mice immunized with pVAX-ROP54 elicited a high level of specific antibody responses, a significant increase of lymphocyte proliferation, and a significant level of Th1-type cytokines (IFN-γ, IL-2 and IL-12p70), in addition to an increased production of Th2-type cytokines (IL-4 and IL-10). These results demonstrated that pVAX-ROP54 induced significant cellular and humoral (Th1/Th2) immune responses, which extended the survival time (13.0±1.15days for pVAX-ROP54 vs 6.7±0.48days for pVAX I, 6.8±0.42days for PBS and 6.5±0.53 for blank control) and significantly reduced cyst burden (35.9% for pVAX-ROP54, 1% for pVAX I and 2% for PBS, compared with blank control) of immunized mice. These results indicate that the recombinant ROP54 plasmid can provide partial protection and might be a potential vaccine candidate against acute and chronic toxoplasmosis. Copyright © 2017 Elsevier B.V. All rights reserved.

[Evaluation of a rapid diagnostic test in the diagnosis of toxoplasmosis in pregnant women in Cotonou (Bénin)].

Science.gov (United States)

Ogouyèmi-Hounto, A; Agbayahoun-Chokki, F; Sissinto Savi de Tove, Y; Biokou Bankole, B; Adinsi de Souza, V; Assogba, M; Kinde-Gazard, D; Massougbodji, A

2014-05-01

The aim of the study was to evaluate the performance of the ImmunoComb® Toxo IgG and ImmunoComb® Toxo IgMassays (rapid diagnostic test) in the laboratory diagnosis of toxoplasmosis in pregnant women in Cotonou. We interviewed 266 pregnant women, who first answered an epidemiological questionnaire, and collected blood samples for measurement of IgG and IgM anti T. gondii antibodies with the ImmunoComb toxo assays and with the ARCHITECT CIMA method. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated to determine the performance of the rapid test. The seroprevalences of IgG against T. gondii by CIMA technique and rapid test were respectively 48.9% and 48.5%. The prevalence increased with age. Performances for IgG were: sensitivity 97%, specificity 100%, PPV 100%, NPV = 97.10%. For IgM, Sensitivity: 33.3% Specificity: 100%, PPV 100%, NPV = 99.2%. Seroprevalence obtained shows that about half of the study population is not immune against T. gondii and requires regular serological monitoring until delivery. According to these results, and given the needs of toxoplasmosis diagnosis on the field characterized by an important decrease of immunized women, this test may be recommended in the laboratory diagnosis of toxoplasmosis in peripheral levels of the health pyramid.

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas

International Nuclear Information System (INIS)

Krestan, C.; Czerny, C.; Gstoettner, W.; Franz, P.

2003-01-01

The role of high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) in the diagnosis of preoperative and postoperative complications caused by acquired cholesteatomas will be described in this paper. The pre- and postoperative imaging of the temporal bone was performed with HRCT and MRI. HRCT and MRI were performed in the axial and coronal plane. MRI was done with T2 weighted and T1 weighted sequences both before and after the intravenous application of contrast material. All imaging findings were confirmed clinically or surgically. The preoperative cholesteatoma-caused complications depicted by HRCT included bony erosions of the ossicles, scutum, facial canal in the middle ear, tympanic walls including the tegmen tympani, and of the labyrinth. The preoperative cholesteatoma-caused complications depicted by MRI included signs indicative for labyrinthitis, and brain abscess. Postoperative HRCT depicted bony erosions caused by recurrent cholesteatoma, bony defects of the facial nerve and of the labyrinth, and a defect of the tegmen tympani with a soft tissue mass in the middle ear. Postoperative MRI delineated neuritis of the facial nerve, labyrinthitis, and a meningo-encephalocele protruding into the middle ear. HRCT and MRI are excellent imaging tools to depict either bony or soft tissue complications or both if caused by acquired cholesteatomas. According to our findings and to the literature HRCT and MRI are complementary imaging methods to depict pre- or postoperative complications of acquired cholesteatomas if these are suspected by clinical examination. (orig.) [de

INTRAOCULAR AND SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN ACUTE RETINAL NECROSIS AND OCULAR TOXOPLASMOSIS

NARCIS (Netherlands)

Wiertz, Karin; De Visser, Lenneke; Rijkers, Ger; De Groot-Mijnes, Jolanda; Los, Leonie; Rothova, Aniki

2010-01-01

Purpose: To determine the intraocular and serum vascular endothelial growth factor (VEGF) levels in patients with acute retinal necrosis (ARN) and compare those with VEGF levels found in patients with ocular toxoplasmosis (OT). Methods: Paired intraocular fluid and serum samples of 17 patients with

Histopathology of murine toxoplasmosis under treatment with dialyzable leukocyte extract

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Beatriz Eugenia Fuentes-Castro

Full Text Available BACKGROUND Dialyzable leukocyte extracts (DLEs contain molecules smaller than 10 kDa with biological activity in receptor organisms. Primarily, they participate in the regulation of the Th1 immune response, which is essential for the control of several intracellular infections, such as toxoplasmosis. This disease is associated with congenital infection, encephalitis or systemic infections in immunocompromised individuals. The clinical course of this infection fundamentally depends on a well-regulated immune response and timely treatment with the appropriate drugs. OBJECTIVE The aim of this study was to evaluate the effect of treatment with a leukocyte extract, derived from crocodile lymphoid tissue, on the histopathology and brain parasite load in NIH mice that had been infected with cysts of Toxoplasma gondii (ME-49 strain. METHODS The treatment was applied during the acute and chronic stages of the infection. Histopathological changes were evaluated in the ileum, liver and spleen at one, four and eight weeks after infection and in the brain at week 8. The parasite load was evaluated by counting the cysts of T. gondii found in the brain. FINDINGS Compared to the control mouse group, the mice infected with T. gondii and under treatment with DLE showed less tissue damage, mainly at the intestinal, splenic and hepatic levels. In addition, a greater percentage of survival was observed, and there was a considerable reduction in the parasite load in the brain. CONCLUSIONS The results suggest that DLE derived from crocodile is a potential adjunctive therapy in the conventional treatment of toxoplasmosis.

Profile of pregnant women and children treated at a reference center for congenital toxoplasmosis in the northern state of Minas Gerais, Brazil

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Janer Aparecida Silveira Soares

2012-02-01

Full Text Available INTRODUCTION: To describe the clinical and epidemiological profile of pregnant women and children treated at a reference outpatient clinic for congenital toxoplasmosis. METHODS: Pregnant women potentially exposed to Toxoplasma gondii were observed. Diagnoses were made using serologic tests compatible with acute toxoplasmosis. Children presenting with: Toxoplasma-specific antibodies (IgM or IgA or ascending IgG titers higher than maternal titers in the first 3 months of life coupled with toxoplasmosis symptoms; intracranial calcifications (by transfontanelar ultrasound or cephalic segment tomography; or retinochoroiditis (by fundoscopy examination in the first 8 months of life were also included in the study. RESULTS: Fifty-eight mother-child pairs were observed (mean age of the mothers was 22.1 years. Most patients lived in urban areas (86.2% and had attended less than 8 years of school (51.7%. Diagnosis was made after birth in 19 (32.8% children. Thirty-four (58.6% women received some type of treatment during pregnancy. Most (72.4% of the children did not present with clinical alterations at birth. The main findings were ophthalmological: 20 (34.5% children with retinochoroiditis, 17 (29.3% with strabismus, and 7 (12.1% with nystagmus. Of the children with retinochoroiditis, 9 presented with subnormal vision. Ten (32.3% out of 31 children presented with intracranial calcifications by cephalic segment congenital toxoplasmosis, and 9 (42.9% children presented with delayed psychomotor development. CONCLUSIONS: Our results highlight a critical situation. Protocols for follow-up of pregnant women and their children must be created to improve medical care and minimize sequelae.

Ocular toxoplasmosis: evaluation of lacrimal - specific secretory IgA levels in both patients with active and inactive phases of the disease

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Luiz Felipe Lynch

2011-08-01

Full Text Available Ocular toxoplasmosis can result in recurrent uveitis. Studies have shown that a correlation between active ocular toxoplasmosis and the presence of anti-Toxoplasma gondii secretory IgA (SIgA in tears. This study compares anti-T. gondii SIgA levels in patients' tears during the acute and inactive phases of toxoplasmic uveitis. Twenty-nine positive tear specific SIgA for T. gondii patients with acute toxoplasmic uveitis were selected and were followed-up for at least two years, when the anti-T. gondii SIgA tears levels were determined. Specific SIgA for T. gondii was negative in 22 patients (75.86% and positive in seven patients (24.13% of whom six (85.7% were followed over three years. Average SIgA levels during the acute phase are 1.54 and decrease significantly to 0.72 (p = 0.0001 during the inactive phase of disease. Because anti-T. gondii SIgA in the tear is negative in 75.86% of patients after the acute phase of infection, T. gondii SIgA levels may be used as a complementary diagnostic marker for active ocular toxoplasmosis.

Case-control study of an outbreak of acute toxoplasmosis in an industrial plant in the state of São Paulo, Brazil.

Science.gov (United States)

Ekman, Claudio Cesar Jaguaribe; Chiossi, Maria Fernanda do Valle; Meireles, Luciana Regina; Andrade Júnior, Heitor Franco de; Figueiredo, Walter Manso; Marciano, Maria Aparecida Moraes; Luna, Expedito José de Albuquerque

2012-01-01

Foodborne diseases represent operational risks in industrial restaurants. We described an outbreak of nine clustered cases of acute illness resembling acute toxoplasmosis in an industrial plant with 2300 employees. These patients and another 36 similar asymptomatic employees were diagnosed with anti-T. gondii IgG titer and avidity by ELISA. We excluded 14 patients based on high IgG avidity and chronic toxoplasmosis: 13 from controls and one from acute disease other than T. gondii infection. We also identified another three asymptomatic employees with T.gondii acute infection and also anti-T. gondii IgM positive as remaining acute cases. Case control study was conducted by interview in 11 acute infections and 20 negative controls. The ingestion of green vegetables, but not meat or water, was observed to be associated with the incidence of acute disease. These data reinforce the importance of sanitation control in industrial restaurants and also demonstrate the need for improvement in quality control regarding vegetables at risk for T. gondii oocyst contamination. We emphasized the accurate diagnosis of indexed cases and the detection of asymptomatic infections to determine the extent of the toxoplasmosis outbreak.

Case-control study of an outbreak of acute toxoplasmosis in an industrial plant in the state of São Paulo, Brazil

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Claudio Cesar Jaguaribe Ekman

2012-10-01

Full Text Available Foodborne diseases represent operational risks in industrial restaurants. We described an outbreak of nine clustered cases of acute illness resembling acute toxoplasmosis in an industrial plant with 2300 employees. These patients and another 36 similar asymptomatic employees were diagnosed with anti-T. gondii IgG titer and avidity by ELISA. We excluded 14 patients based on high IgG avidity and chronic toxoplasmosis: 13 from controls and one from acute disease other than T. gondii infection. We also identified another three asymptomatic employees with T.gondii acute infection and also anti-T. gondii IgM positive as remaining acute cases. Case control study was conducted by interview in 11 acute infections and 20 negative controls. The ingestion of green vegetables, but not meat or water, was observed to be associated with the incidence of acute disease. These data reinforce the importance of sanitation control in industrial restaurants and also demonstrate the need for improvement in quality control regarding vegetables at risk for T. gondii oocyst contamination. We emphasized the accurate diagnosis of indexed cases and the detection of asymptomatic infections to determine the extent of the toxoplasmosis outbreak.

An overview of seventy years of research (1944–2014) on toxoplasmosis in Colombia, South America

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This study reviews toxoplasmosis research in Colombia, beginning with the first report of Toxoplasma gondii infection in 1944. Here we summarize prevalence of T. gondii in humans and animals and associated correlates of infection, clinical spectrum of disease in humans, and genetic diversity of T. g...

The incidence and economic significance of ovine toxoplasmosis in Uruguay.

Science.gov (United States)

Freyre, A; Bonino, J; Falcón, J; Castells, D; Correa, O; Casaretto, A

1999-02-01

Antibodies to Toxoplasma gondii were measured before and after pregnancy in a 1:64 dilution of sera with the direct agglutination test in 1613 ewes from 18 farms in eight different counties of Uruguay from 1992 to 1994. The overall seroprevalence increased from 28.7% before mating to 38.5% after lambing in 2.5 years and thus the incidence was 9.8%. Losses due to toxoplasmosis during pregnancy were estimated to be 1.4-3.9% of the total number of ewes investigated, amounting to approximately US$1.4-4.7 million for the whole country.

Latent toxoplasmosis is associated with neurocognitive impairment in young adults with and without chronic HIV infection.

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Ene, L; Marcotte, T D; Umlauf, A; Grancea, C; Temereanca, A; Bharti, A; Achim, C L; Letendre, S; Ruta, S M

2016-10-15

We evaluated the impact of latent toxoplasmosis (LT) on neurocognitive (NC) and neurobehavioural functioning in young adults with and without chronic HIV infection, using a standardised NC test battery, self-reported Beck Depression Inventory, Frontal System Behavior Scale, MINI-International Neuropsychiatric Interview and risk-assessment battery. 194 young adults (median age 24years, 48.2% males) with chronic HIV infection (HIV+) since childhood and 51 HIV seronegative (HIV-) participants were included. HIV+ individuals had good current immunological status (median CD4: 479 cells/μl) despite a low CD4 nadir (median: 93 cells/μl). LT (positive anti-Toxoplasma IgG antibodies) was present in one third of participants. The impairment rates in the HIV- with and without Toxo were not significantly different (p=0.17). However, we observed an increasing trend (pToxoplasmosis may contribute to NC impairment in young adults, including those with and without chronic HIV infection. Copyright © 2016 Elsevier B.V. All rights reserved.

Toxoplasmose em primatas neotropicais: estudo retrospectivo de sete casos Toxoplasmosis in New World primates: Retrospective study of seven cases

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Renata A. Casagrande

2013-01-01

common clinical signs were apathy and anorexia (5/7, abdominal distension (4/7 and fever (3/7. The main gross lesions were splenomegaly (4/7, hemorrhage in digestory system, lymph nodes and urinary bladder (4/7, reddish lungs (3/7 and hepatomegaly (2/7. Histopathological findings were necrotizing hepatitis (7/7, splenitis (3/7, myocarditis (2/7, enteritis (2/7, lymphadenitis (1/7 and sialitis (1/7, and interstitial pneumonia (4/7. In the liver, lungs, spleen, heart, lymph nodes and salivary gland there were tachyzoites of Toxoplasma gondii that also detected by immunohistochemistry against T. gondii in liver, spleen and lungs (5/7. Toxoplasmosis can cause high mortality in New World primate colonies and can be a threat to preservation of those species in captivity. Therefore, preventive measures should be taken to avoid the contamination of those animals.

Treatment of infants with congenital toxoplasmosis: Tolerability and plasma concentrations of sulfadiazine and pyrimethamine

DEFF Research Database (Denmark)

Schmidt, D.R.; Høgh, B; Andersen, O

2006-01-01

The aim was to study the tolerability and plasma concentrations of pyrimethamine and sulfadiazine in children treated for congenital toxoplasmosis. Infants were diagnosed through the Danish Toxoplasma Neonatal Screening Programme, based on detection of toxoplasma-specific IgM- and/or IgA-antibodi......The aim was to study the tolerability and plasma concentrations of pyrimethamine and sulfadiazine in children treated for congenital toxoplasmosis. Infants were diagnosed through the Danish Toxoplasma Neonatal Screening Programme, based on detection of toxoplasma-specific IgM- and/or Ig...... spectrometric detection. Of 48 infants, 41 completed the treatment without change in schedule. Six infants had neutrophil counts below 0.5x10(9)/l, and one infant had an elevated bilirubin value. Twenty-nine children were tested by a series of neutrophil counts during treatment. The neutrophil count was ... efficacy is still a concern, since progression of eye lesions was observed in three eyes during the follow-up period. We concluded that the treatment was well tolerated in 86% (25/29) of the children. The drugs did not affect their weight gain. Drugs given in the recommended doses led to concentrations...

Pneumonia - children - community acquired

Science.gov (United States)

Bronchopneumonia - children; Community-acquired pneumonia - children; CAP - children ... Viruses are the most common cause of pneumonia in infants and children. Ways your child can get CAP include: Bacteria and viruses living in the nose, sinuses, or mouth may spread ...

Epidemiology of and Diagnostic Strategies for Toxoplasmosis

Science.gov (United States)

Dardé, Marie-Laure

2012-01-01

Summary: The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies. PMID:22491772

Nervous system manifestations and neuroradiologic findings in acquired immunodeficiency syndrome (AIDS)

International Nuclear Information System (INIS)

Rodesch, G.; Parizel, P.M.; Lalmand, B.; Vanderhofstadt, A.; Baleriaux, D.; Farber, C.M.; Calck, M. van; Przedborski, S.; Haens, J. d'; Taelman, H.

1989-01-01

We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed. Five were homosexual men and eight patients (5 men, 3 women) were of African origin (Zaire and Rwanda) (n=5) or had had sexual intercourse with the local African population (n=3). The nervous system complications encountered included: Toxoplasma gondii brain abscess (2 patients); cryptococcus neoformans meningitis+toxoplasmosis (1 patient); toxoplasmosis+lymphoma (2 patients); progressive multifocal leucoencephalopathy (1 patient); lymphocytic meningitis or encephalitis (3 patients); lymphoma (1 patient); polyradiculoneuritis (3 patients). Three of thirteen patients had multiple intracranial abnormalities: One had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis; in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess; conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma. In conclusion, in our experience, nervous system toxoplasmosis is the most frequent AIDS related CNS complication. Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately. In these cases, while CT may readily identify the intracranial abnormalities, it contributes little towards an etiological diagnosis. Finally, our series illustrates the importance of a central African endemic focus for AIDS. (orig.)

Nervous system manifestations and neuroradiologic findings in acquired immunodeficiency syndrome (AIDS)

Energy Technology Data Exchange (ETDEWEB)

Rodesch, G.; Parizel, P.M.; Lalmand, B.; Vanderhofstadt, A.; Baleriaux, D.; Farber, C.M.; Calck, M. van; Przedborski, S.; Haens, J. d' ; Taelman, H.

1989-03-01

We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed. Five were homosexual men and eight patients (5 men, 3 women) were of African origin (Zaire and Rwanda) (n=5) or had had sexual intercourse with the local African population (n=3). The nervous system complications encountered included: Toxoplasma gondii brain abscess (2 patients); cryptococcus neoformans meningitis+toxoplasmosis (1 patient); toxoplasmosis+lymphoma (2 patients); progressive multifocal leucoencephalopathy (1 patient); lymphocytic meningitis or encephalitis (3 patients); lymphoma (1 patient); polyradiculoneuritis (3 patients). Three of thirteen patients had multiple intracranial abnormalities: One had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis; in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess; conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma. In conclusion, in our experience, nervous system toxoplasmosis is the most frequent AIDS related CNS complication. Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately. In these cases, while CT may readily identify the intracranial abnormalities, it contributes little towards an etiological diagnosis. Finally, our series illustrates the importance of a central African endemic focus for AIDS.

Immunodiagnosis and molecular validation of Toxoplasma gondii-recombinant dense granular (GRA) 7 protein for the detection of toxoplasmosis in patients with cancer.

Science.gov (United States)

Arab-Mazar, Zahra; Fallahi, Shirzad; Koochaki, Ameneh; Haghighi, Ali; Seyyed Tabaei, Seyyed Javad

2016-02-01

Serological assays for the diagnosis of toxoplasmosis mostly rely on the tachyzoite specific antigens of Toxoplasma gondii, which are difficult to produce by conventional methods. The aim of this study was to clone and express of GRA7 protein of T. gondii and evaluate its potential for immunodiagnosis of toxoplasmosis in cancer patients. As well as validate the results using a new molecular assay, LAMP technique. The GRA7 gene was successfully cloned, expressed and purified by affinity chromatography and the production was evaluated by SDS PAGE, dot blot and western blot analyses. The rGRA7 was used for developing an ELISA based on the rGRA7 using sera from patients with toxoplasmosis and healthy controls. Furthermore, 50 serum samples from leukemic children infected with toxoplasmosis and 50 seronegative controls were included to evaluate the sensitivity and specificity of rGRA7 based ELISA. Finally, the LAMP technique was used to assess the accuracy and validity of the results obtained by rGRA7 based ELISA. The consistency of the results of two tests was determined by using the Kappa coefficient of agreement. The rGRA7 showed higher and optimum immunoreactivity with 1:100 dilution of serum from Toxoplasma infected patients. The sensitivity and specificity of test were calculated as 92 and 94%, respectively. According to the Kappa coefficient of agreement, there was a significant conformance between the results obtained by ELISA based on the rGRA7 and the results of LAMP technique (≈96%, Ptoxoplasmosis in patients including patients with cancer. Copyright © 2015. Published by Elsevier GmbH.

Descripción de un brote epidémico de toxoplasmosis aguda en pacientes inmunocompetentes miembros de las fuerzas militares de Colombia durante operaciones de selva Description of an epidemic outbreak of acute toxoplasmosis in immunocompetent patients from Colombian Armed Forces during jungle operations

Directory of Open Access Journals (Sweden)

Luis Eduardo Pino

2009-06-01

Full Text Available La toxoplasmosis es una de las infecciones oportunistas más frecuentes en los pacientes infectados con el virus de inmunodeficiencia humana (VIH, mientras que, en los pacientes inmunocompetentes, la infección es sintomática sólo en 10% a 20% de los casos, generalmente con un comportamiento benigno y autolimitado. En la última década se han informado casos graves de compromiso visceral por toxoplasmosis aguda en pacientes inmunocompetentes. En este artículo se presenta un brote epidémico causado por Toxoplasma gondii en personal militar durante el desarrollo de operaciones de selva en el área general de La Macarena, Meta, Colombia. Los 18 casos reportados se confirmaron mediante inmunofluorescencia indirecta (IFI de anticuerpos IgG anti-toxoplasma, al obtener títulos iguales o superiores a 1:1.024 (valor negativo inferior a 1:16. Los síntomas más importantes en estos pacientes fueron fiebre prolongada, adenopatías y compromiso pulmonar y gastrointestinal. Un paciente desarrolló compromiso miopericárdico grave. Todos los pacientes se recuperaron después de tratamiento con pirimetamina/sulfodaxina y clindamicina durante tres semanas. Una hipótesis para la presentación del brote epidémico es el consumo de agua contaminada con ooquistes y, probablemente, la seriedad del compromiso puede atribuirse a una cepa silvestre del parásito, tal como se ha descrito en otros casos reportados en la literatura, aunque en nuestro caso en particular, no se pudo realizar el aislamiento y tipificación de las cepas involucradas.Toxoplasmosis is a common opportunistic infection in patients infected with HIV/AIDS while in immunocompetent patients this infection causes symptoms only in 10% to 20% of the cases, generally with a benign and autoresolutive course. In the last decade some severe cases with visceral involvement has been reported in immunocompetent patients, though they were isolated or recovered during years. We present the first Colombian

Comportamiento de la toxoplasmosis ocular activa en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" Behavior of the active ocular toxoplasmosis in patients of the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology

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Eddy Mesa Hernández

2011-06-01

Full Text Available OBJETIVO: Describir los hallazgos patológicos en una serie de pacientes con toxoplasmosis ocular. MÉTODOS: Se realizó un estudio observacional descriptivo de serie de casos, con el propósito de describir el comportamiento de la forma activa de la toxoplasmosis ocular en pacientes atendidos en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer" durante el año 2009. Se examinaron 128 pacientes, a quienes se les efectuó examen oftalmológico completo y de laboratorio. RESULTADOS: La forma de presentación más común fue una retinitis, y el grupo etáreo más afectado fue el de 20 a 29 años, con ligero predominio del sexo femenino. La disminución de la visión y los flotadores fueron los principales síntomas de presentación, y el diagnóstico se realizó en 106 pacientes de forma clínica. La inflamación predominó en la zona I de la retina y dañó principalmente, de manera moderada, la visión de los pacientes en el ojo afectado al momento del diagnóstico. Se instauró tratamiento en 122 de los 128 pacientes y este fue en su mayoría el esquema estándar de pirimetamina, sulfadiazina y prednisona. El 53,1 % de los ojos afectados recuperaron su visión normal, mientras permanecieron con disminución de la visión severa 34 ojos, la mayoría causada por complicaciones como cicatrices maculares, que fueron las más registradas. CONCLUSIONES: Buenos resultados visuales pueden ser obtenidos con una terapia adecuada aunque esta dependerá del área de la retina afectada, el nivel de la inflamación intraocular y el tiempo de duración de la enfermedad.OBJECTIVE: To describe the pathological findings in a series of patients diagnosed with ocular toxoplasmosis. METHODS: A case-series, descriptive and observational study was conducted to describe the behavior of the active way of the ocular toxoplasmosis in patients seen in the "Ramón Pando Ferrer" Cuban Institute of Ophthalmology over 2009. A total of 128 were examined who underwent a

Acquired cavo-varus deformity caused by an accessory calcaneus: a case report and literature review

International Nuclear Information System (INIS)

Singh Baghla, Davinder Paul; Shariff, Sajid; Bashir, Waseem A.

2010-01-01

We describe an unusual cause of an acquired cavo-varus foot deformity produced by progressive enlargement of an accessory calcaneal ossicle. A 13-year-old boy with constitutional plano-valgus flat feet noted a gradual change in foot shape associated with lateral ankle pain on ambulation following an inversion injury 2 years earlier. CT and MRI scans confirmed a large accessory calcaneal ossicle lying within the sinus tarsi, with associated marrow oedema. Following surgical excision of the ossicle, the foot returned to its original shape and the symptoms were alleviated. This is the fifth reported case of an accessory calcaneal ossicle, but the only case that has occurred in a flatfooted individual. We also present the first reported MRI images of the lesion confirming pathological marrow oedema as a response to mechanical stress. (orig.)

Experimental infection with the Toxoplasma gondii ME-49 strain in the Brazilian BR-1 mini pig is a suitable animal model for human toxoplasmosis

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Farlen José Bebber Miranda

2015-02-01

Full Text Available Toxoplasma gondii causes toxoplasmosis, a worldwide disease. Experimentation with pigs is necessary for the development of new therapeutic approaches to human diseases. BR-1 mini pigs were intramuscularly infected with T. gondii with tachyzoites (RH strain or orally infected with cysts (ME-49 strain. Haematology and serum biochemistry were analysed and buffy coat cells were inoculated in mice to determine tachyzoite circulation. No alterations were observed in erythrocyte and platelet values; however, band neutrophils increased seven days after infection with ME-49. Serology of the mice inoculated with pig blood leucocytes revealed circulating ME-49 or RH strain tachyzoites in the pigs' peripheral blood at two and seven or nine days post-infection. The tachyzoites were also directly observed in blood smears from the infected pigs outside and inside leucocytes for longer periods. Alanine-aminotransferase was high at days 21 and 32 in the RH infected pigs. After 90 days, the pigs were euthanised and their tissue samples were processed and inoculated into mice. The mice serology revealed the presence of parasites in the hearts, ileums and mesenteric lymph nodes of the pigs. Additionally, cysts in the mice were only observed after pig heart tissue inoculation. The infected pigs presented similar human outcomes with relatively low pathogenicity and the BR-1 mini pig model infected with ME-49 is suitable to monitor experimental toxoplasmosis.

Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus ST30-SCCmecIVc-spat019-PVL positive in San Antonio de Areco, Argentina

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Silvina Fernández

2015-03-01

Full Text Available Community-acquired methicillin-resistant Staphylococcus aureus is the first cause of skin and soft tissue infections, but can also produce severe diseases such as bacteremia, osteomyelitis and necrotizing pneumonia. Some S. aureus lineages have been described in cases of necrotizing pneumonia worldwide, usually in young, previously healthy patients. In this work, we describe a fatal case of necrotizing pneumonia due to community-acquired methicillin-resistant S. aureus clone ST30-SCCmecIVc-spat019-PVL positive in an immunocompetent adult patient.

[Causes of lymphocytic meningitis in people with HIV admitted to the Infectious Disease department of Conakry].

Science.gov (United States)

Traoré, F A; Cissoko, Y; Tounkara, T M; Sako, F B; Mouelle, A D; Kpami, D O; Traoré, M; Doumbouya, M

2015-01-01

The advent of HIV infection has significantly changed the distribution of the causes of lymphocytic meningitis. The objective of this study was to identify these causes among persons with HIV hospitalized in the infectious disease department of the CHU of Conakry. This retrospective study examined hospital records of patients with HIV infection admitted for lymphocytic meningitis over a 10-year period. Of the 8649 hospitalizations in the department during the study period, 3167 patients had HIV infection, and 85 of the latter were diagnosed with lymphocytic meningitis. Slightly more than half were male (sex ratio M/F = 1.1). Their mean age was 32 years. Of these 85 patients, 73 were positive for HIV-1 only and 12 for HIV1+2. A CD4 count was performed only in 13/85 patients and averaged 140 cells/mm3. The main causes associated with lymphocytic meningitis were cryptococcosis (58%), toxoplasmosis (5%), and tuberculosis (2%). Streptococcus pneumoniae, Neisseria meningitidis, and Hæmophilus influenzae were also identified in 16% of cases. In 18% of cases no microbe was identified. The overall lethality rate was 68%; it reached 100% for tuberculous meningitis and for the cases without any identified cause and was 75%-76% for the patients with toxoplasmosis and cryptococcosis. The survival rate was 100% for all bacterial causes. A cause for lymphocytic meningitis was identified in more than 81% of the patients in our series, and the most common microbe was Cryptococcus neoformans. A better microbiological technical platform and improved accessibility to treatment would enable us to provide more relevant results and treatment.

Timing of positive blood samples does not differentiate pathogens causing healthcare-associated from community-acquired bloodstream infections in children in England: a linked retrospective cohort study

OpenAIRE

HENDERSON, K. L.; M?LLER-PEBODY, B.; WADE, A.; SHARLAND, M.; MINAJI, M.; JOHNSON, A. P.; GILBERT, R

2014-01-01

SUMMARY Paediatricians recognize that using the time-dependent community-acquired vs. hospital-acquired bloodstream infection (BSI) dichotomy to guide empirical treatment no longer distinguishes between causative pathogens due to the emergence of healthcare-associated BSIs. However, paediatric epidemiological evidence of the aetiology of BSIs in relation to hospital admission in England is lacking. For 12 common BSI-causing pathogens in England, timing of laboratory reports of positive paedia...

Acquired ventricular septal defect due to infective endocarditis

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Randi E Durden

2018-01-01

Full Text Available Acquired intracardiac left-to-right shunts are rare occurrences. Chest trauma and myocardial infection are well-known causes of acquired ventricular septal defect (VSD. There have been several case reports describing left ventricle to right atrium shunt after infective endocarditis (IE. We present here a patient found to have an acquired VSD secondary to IE of the aortic and tricuspid valves in the setting of a known bicuspid aortic valve. This is the first case reported of acquired VSD in a pediatric patient in the setting of IE along with literature review of acquired left-to-right shunts.

Fatal extraintestinal toxoplasmosis in a young male cat with enlarged mesenteric lymph nodes.

Science.gov (United States)

Cohen, Tamara M; Blois, Shauna; Vince, Andrew R

2016-05-01

A 22-month-old indoor/outdoor neutered male domestic short-haired cat had a history of progressive lethargy, vomiting, and decreased appetite. Abdominal ultrasound revealed an irregular hyperechoic mass in the mid-abdomen. He was unresponsive to symptomatic medical management and was euthanized after 3 days of hospitalization. A diagnosis of disseminated extraintestinal toxoplasmosis was made based on the finding of intracytoplasmic protozoan parasites on histopathological examination of mesenteric lymph nodes, hepatic and intestinal samples, and on immunohistochemistry.

Fatal toxoplasmosis in a vinaceous Amazon parrot (Amazona vinacea).

Science.gov (United States)

Ferreira, Francisco Carlos; Donatti, Rogerio Venâncio; Marques, Marcus Vinícius Romero; Ecco, Roselene; Preis, Ingred Sales; Shivaprasad, H L; Vilela, Daniel Ambrózio da Rocha; Martins, Nelson Rodrigo da Silva

2012-12-01

Toxoplasmosis was diagnosed in a vinaceous Amazon parrot based on histopathology and immunohistochemistry. The bird was prostrate on the bottom of the cage and died. Necropsy revealed edema and congestion of the lungs, cloudy air sacs, and mild hepatomegaly. Histopathology revealed severe pulmonary congestion and edema and interstitial mononuclear cell inflammation associated with many cysts containing bradyzoites of Toxoplasma gondii scattered throughout. The heart had mild multifocal lymphocytic myocarditis and free tachyzoites in the muscle fibers, and the kidneys had mild interstitial nephritis and a few cysts containing bradyzoites of T. gondii. Immunohistochemistry was negative for Sarcocystis falcatula and Neospora caninum and confirmed the protozoa as T. gondii. This is the first description of T. gondii in an endangered species ofa Brazilian psittacine.

Immediate rather than delayed memory impairment in older adults with latent toxoplasmosis.

Science.gov (United States)

Mendy, Angelico; Vieira, Edgar R; Albatineh, Ahmed N; Gasana, Janvier

2015-03-01

The neurotropic parasite Toxoplasma gondii infects one third of the world population, but its effect on memory remains ambiguous. To examine a potential relationship of the infection with immediate and delayed memory, a population-based study was conducted in 4485 participants of the Third National Health and Nutrition Examination Survey aged 60years and older. Serum anti-Toxoplasma IgG antibodies were measured by enzyme immune assay and verbal memory was assessed using the Mini-Mental State Examination and the East Boston Memory Test. The prevalence of latent toxoplasmosis was 41%; in one way analysis of variance, anti-Toxoplasma IgG antibody levels significantly differed across tertiles for immediate (P=0.006) but not delayed memory scores (P=0.22). In multinomial logistic regression adjusting for covariates, Toxoplasma seropositivity was associated with lower immediate memory performance (OR: 0.65, 95% CI: 0.44, 0.97 for medium tertile and OR: 0.61, 95% CI: 0.37, 0.98 for highest tertile in reference to the lowest tertile), especially in non-Hispanic Whites (OR: 0.56, 95% CI: 0.36, 0.88 for medium tertile and OR: 0.51, 95% CI: 0.30, 0.87 for highest tertile in reference to the lowest tertile). However, no relationship with delayed memory was observed. In conclusion, latent toxoplasmosis is widespread in older adults and may primarily affect immediate rather than delayed memory, particularly in White Americans. Copyright © 2014 Elsevier Inc. All rights reserved.

Ophthalmic outcomes of congenital toxoplasmosis followed until adolescence.

Science.gov (United States)

Wallon, Martine; Garweg, Justus G; Abrahamowicz, Michal; Cornu, Catherine; Vinault, Sandrine; Quantin, Catherine; Bonithon-Kopp, Claire; Picot, Stéphane; Peyron, François; Binquet, Christine

2014-03-01

Congenital toxoplasmosis (CT) can elicit severe damage to several organs, especially the eye, and may be manifested at birth or later. We assessed the long-term ocular prognosis in a cohort of congenitally infected children treated according to a standardized protocol and monitored for up to 22 years. This prospective study included confirmed cases of CT, which were identified by obligatory antenatal screening at the Lyon (France) reference center between 1987 and 2008. Data obtained through ocular examinations were recorded on a standardized form and confirmed by an independent external committee. Risk factors for retinochoroiditis were identified by using a multivariable Cox model and a flexible model that accounted for changes in the factor effects during follow-up. A total of 477 of 485 infected live-born children were followed for a median of 10.5 years (75th percentile: 15.0 years). During the follow-up, 142 patients (29.8%) manifested at least 1 ocular lesion. Lesions were unilateral in 98 individuals (69.0%) and caused no vision loss in 80.6%. Lesions were first manifested at a median age of 3.1 (0.0-20.7) years. In 48 (33.8%) of the children, recurrences or new ocular lesions occurred up to 12 years after the appearance of the first lesion. Early maternal infection and confirmation of CT in children, prematurity, and nonocular CT lesions at baseline were associated with a higher risk of retinochoroiditis. Although the consequences of CT are rarely severe in treated children, regular postnatal monitoring is nevertheless justified because of the lifelong persisting risk of new ocular manifestations.

Effects of Thymus vulgaris ethanolic extract on chronic toxoplasmosis in a mouse model.

Science.gov (United States)

Eraky, Maysa Ahmad; El-Fakahany, Amany Farouk; El-Sayed, Nagwa Mostafa; Abou-Ouf, Eman Abdel-Rahman; Yaseen, Doaa Ibrahim

2016-07-01

The current work was undertaken to investigate the potential effectiveness of Thymus vulgaris ethanolic extract (TVE) against Toxoplasma gondii infection in chronic experimental toxoplasmosis. To evaluate prophylactic effects, mice received 500 mg/kg TVE for 5 days before they were infected by an avirulent Me49 T. gondii strain. To investigate the therapeutic effects of the extract postinfection, daily treatment with TVE was initiated at 6 weeks postinfection and continued for 10 days. The following groups of animals were used as controls: uninfected/non-treated, infected/non-treated, and infected/treated with a combination of pyrimethamine and sulfadiazine. Brain cyst count and histopathological changes using H&E and Feulgen stains were used to evaluate the efficacy of TVE. The mean number of brain cysts was significantly decreased by 24 % in mice treated prophylactically with TVE. TVE also significantly reduced the mean number of brain cysts when administered to animals already chronically infected with T. gondii. The effect of TVE was comparable to that of treatment with a mixture of sulfadiazine and pyrimethamine (46 and 51 % reduction, respectively). Moreover, considerable amelioration of the pathological lesions in the brain and retina was observed. The results demonstrate the potential efficacy of T. vulgaris as a new natural therapeutic and prophylactic agent for use in the treatment of chronic toxoplasmosis.

Long-term sera storage does not significantly modify the interpretation of toxoplasmosis serologies.

Science.gov (United States)

Dard, C; Bailly, S; Drouet, T; Fricker-Hidalgo, H; Brenier-Pinchart, M P; Pelloux, H

2017-03-01

Serological investigation of Toxoplasma gondii can answer many questions about toxoplasmosis in human pathology. Along these lines, studies on serum storage in biobanks need to be performed especially in terms of determining the impact of storage on relevance of sera analysis after freezing. This study assessed the impact of long-term sera storage on the stability of anti-Toxoplasma immunoglobulins. The stability of anti-Toxoplasma IgG and IgM was studied in 244 and 242 sera respectively, stored at -20°C from one month to ten years. ELISA-immunoassay (Vidas®, bioMérieux) was used for initial and post-storage analyses. Linear models for repeated measures and subgroup analyses were performed to assess the effect of storage duration and sample characteristics on immunoglobulins stability. Until ten years, the variability attributed to storage (maximum 8.07% for IgG, 13.17% for IgM) was below the variations inherent to the serological technique and allowed by quality assurance systems (15%). Subgroup analysis reported no variation attributed to sera storage. Serological interpretation was modified for 3 sera (1.2%) tested for IgM, all stored more than seven years. Anti-Toxoplasma immunoglobulins can reliably be measured for at least up to six years of storage with no modification of interpretation of toxoplasmosis serologies. Copyright © 2017 Elsevier B.V. All rights reserved.

Early serum biomarker networks in infants with distinct retinochoroidal lesion status of congenital toxoplasmosis.

Science.gov (United States)

de Araújo, Thádia Evelyn; Coelho-Dos-Reis, Jordana Grazziela; Béla, Samantha Ribeiro; Carneiro, Ana Carolina Aguiar Vasconcelos; Machado, Anderson Silva; Cardoso, Ludmila Melo; Ribeiro, Ágata Lopes; Dias, Michelle Hallais França; Queiroz Andrade, Gláucia Manzan; Vasconcelos-Santos, Daniel Vitor; Januário, José Nélio; Teixeira-Carvalho, Andréa; Vitor, Ricardo Wagner Almeida; Ferro, Eloisa Amália Vieira; Martins-Filho, Olindo Assis

2017-07-01

The present study characterized the early changes in the serum chemokines/cytokine signatures and networks in infants with congenital-toxoplasmosis/(TOXO) as compared to non-infected-controls/(NI). TOXO were subgrouped according to the retinochoroidal lesion status as no-lesion/(NL), active-lesion/(ARL), active/cicatricial-lesion/(ACRL) and cicatricial-lesion/(CRL). The results showed that TOXO display prominent chemokine production mediated by IL-8/CXCL8, MIG/CXCL9, IP-10/CXCL10 and RANTES/CCL5. Additionally, TOXO is accompanied by mixed proinflammatory/regulatory cytokine pattern mediated by IL-6, IFN-γ, IL-4, IL-5 and IL-10. While TNF appears as a putative biomarker for NL and IFN-γ/IL-5 as immunological features for ARL, IL-10 emerges as a relevant mediator in ACRL/CRL. IL-8/CXCL8 and IP-10/CXCL10 are broad-spectrum indicators of ocular disease, whereas TNF is a NL biomarker, IFN-γ and MIG/CXCL9 point out to ARL; and IL-10 is highlighted as a genuine serum biomarker of ACRL/CRL. The network analysis demonstrated a broad chemokine/cytokine crosstalk with divergences in the molecular signatures in patients with different ocular lesions during congenital toxoplasmosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of two DNA targets for the diagnosis of Toxoplasmosis by real-time PCR using fluorescence resonance energy transfer hybridization probes

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Ernault Pauline

2003-05-01

Full Text Available Abstract Background Toxoplasmosis is an infectious disease caused by the parasitic protozoan Toxoplasma gondii. It is endemic worldwide and, depending on the geographic location, 15 to 85% of the human population are asymptomatically infected. Routine diagnosis is based on serology. The parasite has emerged as a major opportunistic pathogen for immunocompromised patients, in whom it can cause life-threatening disease. Moreover, when a pregnant woman develops a primary Toxoplasma gondii infection, the parasite may be transmitted to the fetus and cause serious damnage. For these two subpopulations, a rapid and accurate diagnosis is required to initiate treatment. Serological diagnosis of active infection is unreliable because reactivation is not always accompanied by changes in antibody levels, and the presence of IgM does not necessarily indicate recent infection. Application of quantitative PCR has evolved as a sensitive, specific, and rapid method for the detection of Toxoplasma gondii DNA in amniotic fluid, blood, tissue samples, and cerebrospinal fluid. Methods Two separate, real-time fluorescence PCR assays were designed and evaluated with clinical samples. The first, targeting the 35-fold repeated B1 gene, and a second, targeting a newly described multicopy genomic fragment of Toxoplasma gondii. Amplicons of different intragenic copies were analyzed for sequence heterogeneity. Results Comparative LightCycler experiments were conducted with a dilution series of Toxoplasma gondii genomic DNA, 5 reference strains, and 51 Toxoplasma gondii-positive amniotic fluid samples revealing a 10 to 100-fold higher sensitivity for the PCR assay targeting the newly described 529-bp repeat element of Toxoplasma gondii. Conclusion We have developed a quantitative LightCycler PCR protocol which offer rapid cycling with real-time, sequence-specific detection of amplicons. Results of quantitative PCR demonstrate that the 529-bp repeat element is repeated more

Epidemic of medical errors and hospital-acquired infections: systemic and social causes

National Research Council Canada - National Science Library

Charney, William

2012-01-01

...) and pharmaceutical errors combined are the second or third leading killer of Americans annually: approximately 300,000 die from a combination of medical errors, hospital acquired infections (HAIs...

New Pneumococcal Carriage Acquired in Association with Acute Respiratory Infection Is Prone to Cause Otitis Media.

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Auranen, Kari; Syrjänen, Ritva; Leino, Tuija; Kilpi, Terhi

2016-01-01

For considering vaccine-prevention of pneumococcal acute otitis media (PncAOM), relationships between pneumococcal carriage, respiratory infection and PncAOM need to be understood. We analyzed nasopharyngeal samples collected from 329 unvaccinated Finnish children aged 2-24 months at scheduled visits and at visits during respiratory infection in 1994-97. We assessed temporal associations of respiratory infection with pneumococcal acquisition and whether PncAOM hazard depends on the relative timing of acquisition and the infection onset. The data comprised 607 person-years of risk-time for acquisition, 245 person-months of concurrent respiratory infection and carriage, and 119 episodes of PncAOM. The acquisition hazard was 3-fold in the month preceding respiratory sickness (hazard ratio, HR 3.5, 90% credible interval CI 2.9, 4.1) as compared to acquisition in healthy children. Moreover, the PncAOM hazard was markedly higher (HR 3.7, 90% CI 2.4, 5.3) during the first month of carriage acquired around the acute phase of respiratory infection (between 1 month before and 1 week after the sickness onset), as compared to carriage acquired later during sickness. The high proportion (76%) of PncAOM events occurring within 1 month of acquisition was due to frequent acquisition being associated with respiratory infection as well as the susceptibility of such acquisition to cause otitis media.

Long-term ocular prognosis in 327 children with congenital toxoplasmosis.

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Wallon, Martine; Kodjikian, Laurent; Binquet, Christine; Garweg, Justus; Fleury, Jacques; Quantin, Catherine; Peyron, François

2004-06-01

Retinochoroiditis is the most frequent consequence of congenital toxoplasmosis. Early diagnosis and treatment are believed to reduce the risk of visual impairment. We report on the clinical evolution of ocular lesions and final visual function in a prospective cohort of congenitally infected children who were identified during monthly maternal prenatal screening. The study included 327 congenitally infected children who were monitored for up to 14 years at the Croix Rousse Hospital in Lyon, France. Data on date of maternal infection; time and type of therapy; antenatal, neonatal, and postnatal work-ups; and ocular status were analyzed. All mothers but 52 had been treated. Pyrimethamine and sulfadiazine was given in utero to 38% of children and after birth to 72% of newborns. Fansidar was given for an average duration of 337 days in all but 2 children. After a median follow-up of 6 years, 79 (24%) children had at least 1 retinochoroidal lesion. In 23 (29%) of them, at least 1 new event had been diagnosed up to 10 years after detection of the first lesions: reactivation of an existing lesion (1 case), new lesion in a previously healthy location (19 cases), or both (3 cases). Fifty-five children had lesions in 1 eye; of the 45 children for whom final visual acuity data were available, 31 (69%) had normal vision. Twenty-four children had lesions in both eyes; of the 21 for whom final visual acuity data were available, 11 had normal vision in both eyes. None had bilateral visual impairment. Clinicians, parents, and elder children with congenital infection should be informed that late-onset retinal lesions and relapse can occur many years after birth but that the overall ocular prognosis of congenital toxoplasmosis is satisfactory when infection is identified early and treated accordingly.

Pulmonary toxoplasmosis in immunocompromised patients with interstitial pneumonia: a single-centre prospective study assessing PCR-based diagnosis.

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Desoubeaux, Guillaume; Cabanne, Églantine; Franck-Martel, Claire; Gombert, Martin; Gyan, Emmanuel; Lissandre, Séverine; Renaud, Marc; Monjanel, Hélène; Dartigeas, Caroline; Bailly, Éric; Van Langendonck, Nathalie; Chandenier, Jacques

2016-08-01

Pulmonary toxoplasmosis has become a very rare parasitic infection since the advent of highly active antiretroviral therapies. It is generally diagnosed by the direct microscopic observation of Toxoplasma gondii tachyzoites in bronchoalveolar lavage fluid (BALF). The aim of this study was to assess possible improvements in diagnostic performance associated with the use of real-time PCR. This prospective study was carried out on BALFs obtained from immunocompromised patients over a 2-year period. We systematically compared the results of conventional staining with those of molecular detection. Two cases of pulmonary toxoplasmosis were diagnosed for a total of 336 samples. PCR did not detect any additional cases and was more time-consuming than conventional staining. Conventional staining is a reliable technique and is probably the most appropriate method for experienced microbiology laboratories, whereas T. gondii-specific PCR may be useful for laboratories with less experience in parasitology. 2015_030, May 27th 2015. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Efecto del tratamiento prenatal con espiramicina en la frecuencia de retinocoroiditis por toxoplasmosis congénita en una cohorte colombiana

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Liliana María Zuluaga

2017-04-01

Conclusiones. Estos resultados evidencian que el tratamiento con espiramicina durante el embarazo en la toxoplasmosis de la gestación redujo en 96 % (IC95% 33-100 % el riesgo relativo de presentar la enfermedad en el recién nacido.

Prevalence of toxoplasmosis in pregnant women and vertical transmission of Toxoplasma gondii in patients from basic units of health from Gurupi, Tocantins, Brazil, from 2012 to 2014.

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Gontijo da Silva, Marcos; Clare Vinaud, Marina; de Castro, Ana Maria

2015-01-01

Toxoplasmosis is a parasitary disease that presents high rates of gestational and congenital infection worldwide being therefore considered a public health problem and a neglected disease. To determine the prevalence of toxoplasmosis amongst pregnant women and vertical transmission of Toxoplasma gondii in their newborns attended in the Basic Units of Health (BUH) from the city of Gurupi, state of Tocantins, Brazil. A prevalence study was performed, including 487 pregnant women and their newborns attended in the BUH of the urban zone of the city of Gurupi, state of Tocantins, Brazil, during the period from February 2012 to February 2014. The selection of the pregnant women occurred by convenience. In the antenatal admission they were invited to participate in this study. Three samples of peripheral blood were collected for the detection of specific anti-T. gondii IgG, IgM and IgA through ELISA, for the polimerase chain reaction (PCR) and IgG avidity during pregnancy. When IgM antibodies were detected the fetal and newborn infection investigation took place. The newborn was investigated right after birth and after one year of age through serology and PCR to confirm/exclude the vertical transmission. The analyses were performed in the Studies of the Host-Parasite Relationship Laboratory (LAERPH, IPTSP-UFG), Goiania, state of Goias, Brazil. The results were inserted in a data bank in Epi-Info 3.3.2 statistic software in which the analysis was performed with p≤5%. The toxoplasmosis infection was detected in 68.37% (333/487, CI95%: 64.62-72.86). The toxoplasmosis chronic infection prevalence was of 63.03% (307/487, CI95%: 58.74-67.32). The prevalence of maternal acute infection was of 5.33% (26/487; CI95%: 3.3-7.3) suspected by IgM antibodies detection in the peripheral blood. The prevalence of confirmed vertical transmission was of 28% (7/25; CI95%: 10.4-45.6). These results show an elevated prevalence of toxoplasmosis in pregnant women and vertical transmission of T

Seroprevalence of Toxoplasmosis Detected by RDT in Residents near the DMZ (demilitarized zone) of Cheorwon-gun, Gangwon-do, Korea.

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Kim, Yeong Hoon; Lee, Jihoo; Kim, Young-Eun; Ahn, Seongkyu; Kim, Tong-Soo; Hong, Sung-Jong; Chong, Chom-Kyu; Ahn, Hye-Jin; Nam, Ho-Woo

2017-08-01

Seroprevalence of Toxoplasma gondii infection among the residents of Cheorwon-gun, Gangwon-do, Korea, which partly includes the demilitarized zone (DMZ), were surveyed for 4 years and evaluated by RDT using recombinant fragment of major surface antigen (SAG1A). Sera from 1336, 583, 526, and 583 adult residents were collected on a yearly basis from 2010 to 2013, respectively. The total positive seroprevalence was 19.3, 21.9, 23.4, and 26.8% from 2010 to 2013, respectively. The positive seroprevalence in men (23.6, 27.5, 29.5, 34.6%) was far higher than women (14.1, 18.3, 19.4, 21.4%), from 2010 to 2013, respectively. This high seroprevalence of toxoplasmosis in Cheorwon-gun may have been influenced in part by its geographical locality of the area as it includes the DMZ, where civilian access is strictly limited, thus creating a relatively isolated area that is a well-preserved habitat. Further research is necessary to study the epidemiology of toxoplasmosis in this area.

Neuroradiology of acquired immunodeficiency syndrome

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De La Paz, R.; Enzmann, D.

1988-01-01

This paper discusses MRI and CT scanning in the evaluation of AIDS patients with neurological symptoms. MRI is the more sensitive of the two techniques but has poor tissue specificity. Contrast enhancement and identification of tissue calcification on CT scans may improve tissue characterization, but a specific etiological diagnosis may not be possible with either MRI or CT scanning; confirmation by biopsy or the response to treatment is often needed. The finding of multiple focal cerebral lesions on MRI and CT scans usually indicates T. gondii infection. Toxoplasmosis may, however, coexist with primary CNS lymphoma or with fungal, mycobacterial, or viral infection. The presence of a solitary focal cerebral lesion, especially on MRI scans, suggests lymphoma or infection with an agent other than T. gondii. Focal cerebral lesions show a variety of complex signal patterns on MRI and enhancement patterns on CT, none of which are specific for a single etiology. Focal lesions on MRI and CT scans are usually associated with focal neurological deficits, but a significant minority of these lesions, especially those seen on MRI scans, may cause only generalized complaints, such as headache and encephalopathy. MRI and CT are both useful for monitoring therapy and show a reduction in the size, number, and enhancement of lesions with successful treatment. The authors conclude that, owing to its greater sensitivity, MRI appears to be more useful for detecting recurrent disease

Community-acquired necrotizing pneumonia caused by methicillin-resistant Staphylococcus aureus ST30-SCCmecIVc-spat019-PVL positive in San Antonio de Areco, Argentina.

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Fernandez, Silvina; Murzicato, Sofía; Sandoval, Orlando; Fernández-Canigia, Liliana; Mollerach, Marta

2015-01-01

Community-acquired methicillin-resistant Staphylococcus aureus is the first cause of skin and soft tissue infections, but can also produce severe diseases such as bacteremia, osteomyelitis and necrotizing pneumonia. Some S. aureus lineages have been described in cases of necrotizing pneumonia worldwide, usually in young, previously healthy patients. In this work, we describe a fatal case of necrotizing pneumonia due to community-acquired methicillin-resistant S. aureus clone ST30-SCCmecIVc-spat019-PVL positive in an immunocompetent adult patient. Copyright © 2014 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

Patrón de immunoblotting y niveles de anticuerpos anti-Toxoplasma gondii en suero y humor acuoso de pacientes con lesiones de toxoplasmosis ocular

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Morella Bouchard Pereira

2014-07-01

Full Text Available El objetivo de este estudio fue evaluar en muestras de suero y humor acuoso los niveles de anticuerpos anti-toxoplasma a través del Coeficiente de Goldmann y Witmer (CGW y el patrón de reconocimiento antigénico a través del immunoblotting (IB, en pacientes con serología positiva con y sin lesiones de toxoplasmosis ocular. Se recogieron simultáneamente muestras de suero y humor acuoso de 26 pacientes: un grupo de casos que poseían lesiones retinales de toxoplasmosis ocular en fase activa e inactiva (n=17 y un grupo control que requería cirugía ocular por presencia de cataratas (n=9. Las determinación de IgM e IgG específicas se realizó por ELISA de inmunocaptura e indirecto, respectivamente. Se utilizó la inmunodifusión radial para la cuantificación de la IgG total. El CGW resultó >2, indicativo de producción local de anticuerpos específicos en 12/17 de los casos, mientras que en los controles no se observó, esto evidenció una sensibilidad del 71% y una especificidad de 100%. En IB, la aparición de bandas diferentes en humor acuoso, indicativo de producción local de anticuerpos específicos se observaron en 11/17 de los casos y 1/9 de los controles, reflejando una sensibilidad de 65% y una especificidad de 89%. Al considerar las dos pruebas la sensibilidad se incrementó a un 73%, pero la especificidad disminuyó a 89%. En conclusión el IB es útil como prueba confirmatoria para diagnóstico de toxoplasmosis ocular, pero sólo como un complemento del coeficiente de GW especialmente en pacientes con lesiones atípicas donde el diagnóstico clínico es difícil. Aqueous humor and serum immunoblotting profiles and anti–toxoplasma gondii antibodies in patients with toxoplasmosis-induced retinal lesions Abstract The purpose of this study was to analize the anti-Toxoplasma gondii antibodies levels in serum and aqueous humor samples in patients with ocular toxoplasmosis by using Goldman and Witmer Coefficient (GWC and the

Urinary tract infection caused by community-acquired extended-spectrum β-lactamase-producing bacteria in infants.

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Kim, Yun Hee; Yang, Eun Mi; Kim, Chan Jong

Urinary tract infection (UTI) caused by resistant strains of bacteria is increasingly prevalent in children. The aim of this study was to investigate the clinical characteristics and risk factors for UTI caused by community-acquired extended-spectrum β-lactamase (CA-ESBL)-producing bacteria in infants. This was a retrospective study performed over 5 years in a single Korean center. Hospitalized infants with febrile UTI were enrolled and divided into two groups (CA-ESBL vs. CA non-ESBL UTI). The yearly prevalence was calculated. Baseline characteristics and clinical course such as fever duration, laboratory and radiological findings were compared between the two groups. Risk factors associated with the CA-ESBL UTI were investigated. Among the enrolled infants (n=185), 31 (17%) had CA-ESBL UTI. The yearly prevalence of ESBL of CA-ESBL UTI increased during the study (0% in 2010, 22.2% in 2015). Infants with CA-ESBL UTI had a longer duration of fever after initiating antibiotics (2.0±1.1 vs. 1.5±0.6 days, p=0.020). Cortical defects on renal scan and early treatment failure were more frequent in CA-ESBL (64.5 vs. 42.2%, p=0.023; 22.6 vs. 4.5%, p=0.001). A logistic regression analysis revealed that urinary tract abnormalities and previous UTI were independent risk factors for CA-EBSL UTI (odds ratio, 2.7; p=0.025; 10.3; p=0.022). The incidence of UTI caused by ESBL-producing bacteria has increased in Korean infants. Recognition of the clinical course and risk factors for ESLB-producing UTI may help to determine appropriate guidelines for its management. Copyright © 2016. Published by Elsevier Editora Ltda.

Maternal Serologic Screening to Prevent Congenital Toxoplasmosis: A Decision-Analytic Economic Model

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Stillwaggon, Eileen; Carrier, Christopher S.; Sautter, Mari; McLeod, Rima

2011-01-01

Objective To determine a cost-minimizing option for congenital toxoplasmosis in the United States. Methodology/Principal Findings A decision-analytic and cost-minimization model was constructed to compare monthly maternal serological screening, prenatal treatment, and post-natal follow-up and treatment according to the current French (Paris) protocol, versus no systematic screening or perinatal treatment. Costs are based on published estimates of lifetime societal costs of developmental disabilities and current diagnostic and treatment costs. Probabilities are based on published results and clinical practice in the United States and France. One- and two-way sensitivity analyses are used to evaluate robustness of results. Universal monthly maternal screening for congenital toxoplasmosis with follow-up and treatment, following the French protocol, is found to be cost-saving, with savings of $620 per child screened. Results are robust to changes in test costs, value of statistical life, seroprevalence in women of childbearing age, fetal loss due to amniocentesis, and to bivariate analysis of test costs and incidence of primary T. gondii infection in pregnancy. Given the parameters in this model and a maternal screening test cost of $12, screening is cost-saving for rates of congenital infection above 1 per 10,000 live births. If universal testing generates economies of scale in diagnostic tools—lowering test costs to about $2 per test—universal screening is cost-saving at rates of congenital infection well below the lowest reported rates in the United States of 1 per 10,000 live births. Conclusion/Significance Universal screening according to the French protocol is cost saving for the US population within broad parameters for costs and probabilities. PMID:21980546

Thyrotoxicosis followed by Hypothyroidism due to Suppurative Thyroiditis Caused by Nocardia brasiliensis in a Patient with Advanced Acquired Immunodeficiency Syndrome.

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Teckie, G2; Bhana, S A; Tsitsi, J M L; Shires, R

2014-03-01

Acute thyroiditis is an extremely rare complication of nocardiosis. We report a patient with hyperthyroidism due to suppurative thyroiditis caused by Nocardia brasiliensis. A 38-year-old Black male presented with features of thyrotoxicosis, sepsis and airway obstruction. He had no evidence of underlying thyroid disease, but was severely immunocompromised as a result of acquired immunodeficiency syndrome. He had previously been diagnosed with pulmonary nocardiosis and also had nocardial abscesses on his anterior chest wall. Investigations revealed thyrotoxicosis, with a FT4 of 43.2 pmol/l and a suppressed TSH Nocardia.

Cerebral Toxoplasmosis Masquerading Cns Lymphoma on FDG PET-CT in Post Renal Transplant Patient

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Mukherjee, Anirban; Bal, Chandrasekhar; Tripathi, Madhavi; Das, Chandan Jyoti; Shamim, Shamim Ahmed

2017-01-01

20 year old post renal transplant patient developed recurrent episodes of seizure. MRI revealed focal lesion in right parieto-occipital lobe with perilesional edema. FDG PET-CT revealed multiple hypermetabolic lesions in bilateral cerebral hemisphere. Subsequent biopsy from the lesion demonstrated bradyzoites of Toxoplasma gondii with inflammatory cells and thereby, a confirmatory diagnosis of cerebral toxoplasmosis was made. This case demonstrates the fact that increased FDG uptake in cerebral lesions in post transplant patient should be interpreted with caution and confirmed with histopathological correlation. PMID:28533649

Neurotoxoplasmosis diagnosis for HIV-1 patients by real-time PCR of cerebrospinal fluid

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Fábio Luís Nascimento Nogui

Full Text Available Encephalitis caused by Toxoplasma gondii is the most common cause of central nervous system damage in patients with acquired immunodeficiency syndrome (AIDS. Toxoplasma may infect any of the brain cells, thus leading to non-specific neurotoxoplasmosis clinical manifestations including focused or non-focused signs and symptoms of central nervous system malfunction. Clinical development ranges from insidious display during weeks to experiencing acute general confusion or ultimately fatal onset. Cerebral toxoplasmosis occurs in advanced stages of immunodeficiency, and the absence of anti-toxoplasmosis antibodies by the immunofluorescence method does not allow us to rule out its diagnosis. As specific therapy begins, diagnosis confirmation is sought through clinical and radiological response. There are few accurate diagnosis methods to confirm such cases. We present a method for T. gondii DNA detection by real time PCR-Multiplex. Fifty-one patients were evaluated; 16 patients had AIDS and a presumptive diagnosis for toxoplasmosis, 23 patients were HIV-positive with further morbidities except neurotoxoplasmosis, and 12 subjects were HIV-negative control patients. Real time PCR-Multiplex was applied to these patients' cephalorachidian liquid with a specific T. gondii genome sequence from the 529bp fragment. This test is usually carried out within four hours. Test sensitivity, specificity, positive predictive value, and negative predictive value were calculated according to applicable tables. Toxoplasma gondii assay by real time Multiplex of cephalorachidian fluid was positive for 11 out of 16 patients with AIDS and a presumptive diagnosis for cerebral toxoplasmosis, while none of the 35 control patients displayed such a result. Therefore, this method allowed us to achieve 68.8% sensitivity, 100% specificity, 100% positive predictive value, and 87.8% negative predictive value. Real time PCR on CSF allowed high specificity and good sensitivity among

Significance of anaerobes and oral bacteria in community-acquired pneumonia.

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Kei Yamasaki

Full Text Available BACKGROUND: Molecular biological modalities with better detection rates have been applied to identify the bacteria causing infectious diseases. Approximately 10-48% of bacterial pathogens causing community-acquired pneumonia are not identified using conventional cultivation methods. This study evaluated the bacteriological causes of community-acquired pneumonia using a cultivation-independent clone library analysis of the 16S ribosomal RNA gene of bronchoalveolar lavage specimens, and compared the results with those of conventional cultivation methods. METHODS: Patients with community-acquired pneumonia were enrolled based on their clinical and radiological findings. Bronchoalveolar lavage specimens were collected from pulmonary pathological lesions using bronchoscopy and evaluated by both a culture-independent molecular method and conventional cultivation methods. For the culture-independent molecular method, approximately 600 base pairs of 16S ribosomal RNA genes were amplified using polymerase chain reaction with universal primers, followed by the construction of clone libraries. The nucleotide sequences of 96 clones randomly chosen for each specimen were determined, and bacterial homology was searched. Conventional cultivation methods, including anaerobic cultures, were also performed using the same specimens. RESULTS: In addition to known common pathogens of community-acquired pneumonia [Streptococcus pneumoniae (18.8%, Haemophilus influenzae (18.8%, Mycoplasma pneumoniae (17.2%], molecular analysis of specimens from 64 patients with community-acquired pneumonia showed relatively higher rates of anaerobes (15.6% and oral bacteria (15.6% than previous reports. CONCLUSION: Our findings suggest that anaerobes and oral bacteria are more frequently detected in patients with community-acquired pneumonia than previously believed. It is possible that these bacteria may play more important roles in community-acquired pneumonia.

Immunogenic multistage recombinant protein vaccine confers partial protection against experimental toxoplasmosis mimicking natural infection in murine model

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Yaprak Gedik

2016-01-01

To generate a protective vaccine against toxoplasmosis, multistage vaccines and usage of challenging models mimicking natural route of infection are critical cornerstones. In this study, we generated a BAG1 and GRA1 multistage vaccine that induced strong immune response in which the protection was not at anticipated level. In addition, the murine model was orally challenged with tissue cysts to mimic natural route of infection.

Acquiring Procedural Skills from Lesson Sequences.

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1985-08-13

Teachers of Mathematics . Washington, D)C: NCTM . Brueckner, I..J. (1930) Diagnostic aund remedial teaching in arithmetic. Philadelphia. PA: Winston. Burton...arithmetic and algebra, fr-m multi-lesson curricula. The central hypothesis is that students and teachers obey cc: :-.entions that cause the goal hierarchy...students and • . teachers obey conventions that cause the goal hierarchy of the acquired procedure to be a particular structural function of the sequential

Evaluation of immunoprotection conferred by the subunit vaccines of GRA2 and GRA5 against acute toxoplasmosis in BALB/c mice

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Xiao Teng eChing

2016-04-01

Full Text Available Toxoplasmosis is a foodborne disease caused by Toxoplasma gondii, an obligate intracellular parasite. Severe symptoms occur in the immunocompromised patients and pregnant women leading to fatality and abortions respectively. Vaccination development is essential to control the disease. The T. gondii dense granule antigen 2 and 5 (GRA2 and GRA5 have been targeted in this study because these proteins are essential to the development of parasitophorous vacuole (PV, a specialized compartment formed within the infected host cell. PV is resistance to host cell endosomes and lysosomes thereby protecting the invaded parasite. Recombinant dense granular proteins, GRA2 (rGRA2 and GRA5 (rGRA5 were cloned, expressed, and purified in Escherichia coli, BL21 (DE3 pLysS. The potential of these purified antigens as subunit vaccine candidates against toxoplasmosis were evaluated through subcutaneous injection of BALB/c mice followed by immunological characterization (humoral- and cellular-mediated and lethal challenge against virulent T. gondii RH strain in BALB/c mice. Results obtained demonstrated that rGRA2 and rGRA5 elicited humoral and cellular-mediated immunity in the mice. High level of IgG antibody was produced with the isotype IgG2a/IgG1 ratio of ≈0.87 (p<0.001. Significant increase (p<0.05 in the level of four cytokines (IFN-γ, IL-2, IL-4 and IL-10 was obtained. The antibody and cytokine results suggest that a mix mode of Th1/Th2-immunity was elicited with predominant Th1-immune response inducing partial protection against T. gondii acute infection in BALB/c mice. Our findings indicated that both GRA2 and GRA5 are potential candidates for vaccine development against T. gondii acute infection.

Implementation of Molecular Surveillance After a Cluster of Fatal Toxoplasmosis at 2 Neighboring Transplant Centers.

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Isa, Flonza; Saito, Kohta; Huang, Yao-Ting; Schuetz, Audrey; Babady, N Esther; Salvatore, Steven; Pessin, Melissa; van Besien, Koen; Perales, Miguel-Angel; Giralt, Sergio; Sepkowitz, Kent; Papanicolaou, Genovefa A; Soave, Rosemary; Kamboj, Mini

2016-08-15

After a cluster of fatal toxoplasmosis among stem cell transplant recipients at 2 hospitals, surveillance with polymerase chain reaction (PCR) (blood) was instituted. Rate of reactivation among seropositive recipients was 2.2 and 16%. Parasitemia was successfully managed with preemptive treatment. For seropositive recipients unable to take prophylaxis, toxoplasma PCR surveillance should be routinely performed. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

MRI of fetal acquired brain lesions

International Nuclear Information System (INIS)

Prayer, Daniela; Brugger, Peter C.; Kasprian, Gregor; Witzani, Linde; Helmer, Hanns; Dietrich, Wolfgang; Eppel, Wolfgang; Langer, Martin

2006-01-01

Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images

MRI of fetal acquired brain lesions

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Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)

2006-02-15

Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

Acquired factor VII deficiency associated with acute myeloid leukemia.

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Anoun, Soumaya; Lamchahab, Mouna; Oukkache, Bouchra; Qachouh, Maryam; Benchekroun, Said; Quessar, Asmaa

2015-04-01

Isolated acquired factor VII deficiency is a rare coagulopathy. It has been reported in 31 patients with malignancy, sepsis, postoperatively, aplastic anemia, and during bone marrow transplantation. We discuss, through a new case of acquired factor VII deficiency, the characteristics of this disease when it is associated with acute myeloid leukemia. Acquired factor VII deficiency in hematological diseases can be caused by intensive chemotherapy, infections, or hepatic dysfunction. The best treatment in developing countries remains corticosteroids associated with plasma exchange, frozen plasma, and antibiotics.

Acquired hypofibrinogenemia: current perspectives

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Besser MW

2016-09-01

Full Text Available Martin W Besser,1 Stephen G MacDonald2 1Department of Haematology, 2Department of Specialist Haemostasis, The Pathology Partnership, Addenbrooke’s Hospital, Cambridge, UK Abstract: Acquired hypofibrinogenemia is most frequently caused by hemodilution and consumption of clotting factors. The aggressive replacement of fibrinogen has become one of the core principles of modern management of massive hemorrhage. The best method for determining the patient’s fibrinogen level remains controversial, and particularly in acquired dysfibrinogenemia, could have major therapeutic implications depending on which quantification method is chosen. This review introduces the available laboratory and point-of-care methods and discusses the relative advantages and limitations. It also discusses current strategies for the correction of hypofibrinogenemia. Keywords: Clauss fibrinogen assay, fibrinogen antigen, viscoelastic testing, ­gravimetric fibrinogen assay, PT-derived fibrinogen, functional fibrinogen, direct oral anticoagulant, dysfibrinogenemia, afibrinogenemia

Etiology and anti-microbial sensitivity of organisms causing community acquired pneumonia: A single hospital study

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Resmi U Menon

2013-01-01

Full Text Available Objective: The objective of this study was to identify the common etiological pathogens causing community acquired pneumonia (CAP in our hospital and sensitivity patterns to the common antibiotics used. Materials and Methods: This study was undertaken in a 750 bedded multi-specialty referral hospital in Kerala catering to both urban and semi-urban populations. It is a prospective study of patients who attended the medical out-patient department and those admitted with a clinical diagnosis of CAP, during the year 2009. Data were collected based on detailed patient interview, clinical examination and laboratory investigations. The latter included sputum culture and sensitivity pattern. These were tabulated and percentage incidence of etiological pathogens calculated. The antimicrobial sensitivity pattern was also classified by percentage and expressed as bar diagram. Results: The study showed Streptococcus pneumoniae to be the most common etiological agent for CAP, in our hospital setting. The other organisms isolated in order of frequency were Klebsiella pneumoniae, Pseudomonas aeruginosa, Alpha hemolytic streptococci, Escherichia coli, Beta hemolytic streptococci and atypical coli. S. pneumoniae was most sensitive to linezolid, followed by amoxicillin-clavulanate (augmentin, cloxacillin and ceftriaxone. Overall, the common pathogens causing CAP showed highest sensitivity to amikacin, followed by ofloxacin, gentamycin, amoxicillin-clavulanate (augmentin, ceftriaxone and linezolid. The least sensitivity rates were shown to amoxicillin and cefoperazone. Conclusion: In a hospital setting, empirical management for cases of CAP is not advisable. The present study has shown S. pneumoniae as the most likely pathogen and either linezolid or amikacin as the most likely effective antimicrobial in cases of CAP, in our setting.

Estudio retrospectivo de la aplicación de la amplificación génica cualitativa en muestras biológicas para el seguimiento de la toxoplasmosis en pacientes pediátricos receptores de trasplante de células progenitoras hematopoyéticas

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Mónica G Nigro

Full Text Available La toxoplasmosis es una infección oportunista causada por el parásito Toxoplasma gondii; su infección es grave y de difícil diagnóstico en pacientes que reciben un trasplante alogénico de células progenitoras hematopoyéticas (TCPH. En el Hospital de Pediatría S.A.M.I.C. "Profesor Dr. Juan P. Garrahan"� se realizó la vigilancia postrasplante de 12 pacientes receptores de TCPH mediante la técnica de PCR cualitativa. La necesidad de seguimiento de estos pacientes fue definida por el antecedente de serología positiva para toxoplasmosis en el donante o receptor y ante la imposibilidad de iniciar el uso profiláctico de trimetoprima-sulfametoxazol a causa de la condición hematológica. Dos pacientes presentaron signos de enfermedad por T. gondii con resultado de PCR positivo y recibieron tratamiento con pirimetamina-clindamicina. En otros dos, la toxoplasmosis fue causa de muerte y hallazgo de autopsia, con resultado de PCR negativo. Cuatro pacientes recibieron tratamiento contra toxoplasmosis por la detección de una PCR positiva, sin manifestaciones clínicas. En los cuatro pacientes restantes no se detectaron signos de enfermedad por toxoplasmosis, con resultados de PCR negativos durante el seguimiento. La técnica de PCR cualitativa demostró ser útil para detectar la reactivación de la toxoplasmosis en receptores de TCPH, pero tiene limitaciones para el seguimiento y la toma de decisiones clínicas en pacientes con PCR positiva que persiste en el tiempo y manifestaciones de toxicidad por el tratamiento.

Toxoplasmosis in sand cats (Felis margarita) and other animals in the Breeding Centre for Endangered Arabian Wildlife in the United Arab Emirates

Science.gov (United States)

The Sand cat (Felis margarita) is a small-sized felid occurring in the United Arab Emirates (UAE). The Sand cat captive breeding program at the Breeding Centre for Endangered Arabian Wildlife (BCEAW), Sharjah, UAE, has experienced high newborn mortality rates, and congenital toxoplasmosis was recent...

Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving

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Prusa, Andrea-Romana; Kasper, David C.; Sawers, Larry; Walter, Evelyn; Hayde, Michael

2017-01-01

Background Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. Methodology/Principal findings We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Conclusions/Significance Cost savings under a national program of

Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

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Andrea-Romana Prusa

2017-07-01

Full Text Available Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario.We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years.Cost savings under a national program of prenatal screening for toxoplasma infection and

Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving.

Science.gov (United States)

Prusa, Andrea-Romana; Kasper, David C; Sawers, Larry; Walter, Evelyn; Hayde, Michael; Stillwaggon, Eileen

2017-07-01

Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are

Acquired Duodenal Obstruction in Children

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Jen-Hung Chien

2008-10-01

Full Text Available Traumatic intramural hematoma of the duodenum is a rare cause of acquired duodenal obstruction in children, and a high degree of suspicion is therefore required to make an early and accurate diagnosis. We report a 6-year-old boy whose epigastrium was impacted by the handlebar of his bicycle during a traffic accident. The boy then experienced epigastralgia. Six days later, progressive bilious vomiting suggestive of gastrointestinal obstruction was noted. Imaging studies revealed a large hematoma extending from the fourth portion of the duodenum to the jejunum. Conservative methods of treatment failed to manage his condition. He underwent laparoscopic surgery to evacuate the hematoma. We also report a case of duodenal obstruction in a previously healthy 2-year-old girl who presented for the first time with acute symptoms of proximal intestinal obstruction. Contrast examinations showed apparent barium retention over the stomach and proximal duodenum. She underwent surgery due to persistent obstruction, and a mushroom-like foreign body was detected embedded in the orifice of the windsock duodenal web. After duodenoduodenostomy and removal of the bezoar, she had a smooth recovery and tolerated feeding well. We conclude that blunt abdominal trauma and incomplete duodenal obstruction, such as that caused by duodenal web, should be considered as possible causes of acquired proximal gastrointestinal obstruction in previously healthy children, despite their rarity.

Is chronic toxoplasmosis a risk factor for diabetes mellitus? A systematic review and meta-analysis of case–control studies

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Hamidreza Majidiani

2016-11-01

Conclusion: Despite the limitations such as low number of studies, this meta-analysis suggests chronic toxoplasmosis as a possible risk factor for type 2 DM. However, based on random effects model no statistically significant association was observed between T. gondii and type 1 DM. It is highly recommended for researchers to carry out more accurate studies aiming to better understand this association.

Costo efectividad de diferentes estrategias diagnósticas para detección de toxoplasmosis congénita en el recién nacido

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Liliana Chicaíza-Becerra

Full Text Available Objetivo: Estimar la costo-efectividad para Colombia del diagnóstico de toxoplasmosis congénita en el recién nacido de madre con historia de infección durante el embarazo. Métodos. Se construyó un árbol de decisión en TreeAge ® con desenlace casos correctamente identificados. Las alternativas del modelo fueron: i Western Blot (WB; ii IgM e IgA, con confirmación por WB; iii IgG, IgM e IgA con confirmación por WB y seguimiento con IgG. La perspectiva es la del sistema de salud con cifras expresadas en pesos colombianos de 2010 sin descuento. Resultados: La estrategia de menor costo y efectividad fue la i. La estrategia ii es más cara y más efectiva que la i, y la estrategia iii es más cara y efectiva que las anteriores. El costo de detectar un caso adicional correctamente con la estrategia ii en lugar de la i es de $6.189.871. Este resultado es sensible al costo de la prueba de Western Blot y su sensibilidad, así como a la prevalencia de la toxoplasmosis congénita. El costo de detectar un caso adicional correctamente con la estrategia iii en lugar de la ii es de $65.529.979, resultado que es sensible a la prevalencia de la toxoplasmosis congénita, la sensibilidad de la prueba conjunta de IgM e IgA y la sensibilidad del Western Blot. Según el análisis de sensibilidad probabilístico, si la disponibilidad a pagar (DAP por caso detectado adicional es inferior a $6,7 millones de pesos, es más probable que la estrategia costo-efectiva sea la i; quedando entre $6,7 millones de pesos y $74 millones de pesos la ii, y la iii por encima de $74 millones de pesos. Conclusiones: La alternativa costo-efectiva para Colombia dependerá de la disponibilidad a pagar (DAP por caso adicional detectado de toxoplasmosis congénita. La DAP debería tomar en cuenta la efectividad del tratamiento y los costos evitados por las secuelas de la infección.

Community-Acquired Acute Kidney Injury: A Nationwide Survey in China.

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Wang, Yafang; Wang, Jinwei; Su, Tao; Qu, Zhen; Zhao, Minghui; Yang, Li

2017-05-01

This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. Cross-sectional and retrospective study. A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay. Community-acquired AKI was identified when a patient had AKI that could be defined at hospital admission. The rate, cause, recognition, and treatment of community-acquired AKI were stratified according to hospital type, latitude, and economic development of the regions in which the patients were admitted. All-cause in-hospital mortality and recovery of kidney function at hospital discharge. 4,136 patients with community-acquired AKI were identified during the 2 single-month snapshots (January 2013 and July 2013). Of these, 2,020 (48.8%) had cases related to decreased kidney perfusion; 1,111 (26.9%), to intrinsic kidney disease; and 499 (12.1%), to urinary tract obstruction. In the north versus the south, more patients were exposed to nephrotoxins or had urinary tract obstructions. 536 (13.0%) patients with community-acquired AKI had indications for renal replacement therapy (RRT), but only 347 (64.7%) of them received RRT. Rates of timely diagnosis and appropriate use of RRT were higher in regions with higher per capita gross domestic product. All-cause in-hospital mortality was 7.3% (295 of 4,068). Delayed AKI recognition and being located in northern China were independent risk factors for in-hospital mortality, and referral to nephrology providers was an independent protective factor. Possible misclassification of AKI and community-acquired AKI due to nonstandard definitions and missing data for serum creatinine. The features of community-acquired AKI varied substantially in different regions of China and were closely

Hospital-acquired Klebsiella pneumoniae infections in a paediatric ...

African Journals Online (AJOL)

is an important preventable cause of increased ... between July 2003 and December 2010, who developed a hospital-acquired Klebsiella pneumoniae infection, was undertaken to describe the trend in ..... Bacterial nosocomial pneumonia in.

Immunization with a DNA vaccine encoding Toxoplasma gondii Superoxide dismutase (TgSOD) induces partial immune protection against acute toxoplasmosis in BALB/c mice.

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Liu, Yuan; Cao, Aiping; Li, Yawen; Li, Xun; Cong, Hua; He, Shenyi; Zhou, Huaiyu

2017-06-07

Toxoplasma gondii (T. gondii) is an obligate intracellular protozoan parasite that infects all warm-blooded animals including humans and causes toxoplasmosis. An effective vaccine could be an ideal choice for preventing and controlling toxoplasmosis. T. gondii Superoxide dismutase (TgSOD) might participate in affecting the intracellular growth of both bradyzoite and tachyzoite forms. In the present study, the TgSOD gene was used to construct a DNA vaccine (pEGFP-SOD). TgSOD gene was amplified and inserted into eukaryotic vector pEGFP-C1 and formed the DNA vaccine pEGFP-SOD. Then the BALB/c mice were immunized intramuscularly with the DNA vaccine and those injected with pEGFP-C1, PBS or nothing were treated as controls. Four weeks after the last immunization, all mouse groups followed by challenging intraperitoneally with tachyzoites of T. gondii ME49 strain. Results showed higher levels of total IgG, IgG2α in the sera and interferon gamma (IFN-γ) in the splenocytes from pEGFP-SOD inoculated mice than those unvaccinated, or inoculated with either empty plasmid vector or PBS. The proportions of CD4 + T cells and CD8 + T cells in the spleen from pEGFP-SOD inoculated mice were significantly (p < 0.05) increased compared to control groups. In addition, the survival time of mice immunized with pEGFP-SOD was significantly prolonged as compared to the controls (p < 0.05) although all the mice died. The present study revealed that the DNA vaccine triggered strong humoral and cellular immune responses, and aroused partial protective immunity against acute T. gondii infection in BALB/c mice. The collective data suggests the SOD may be a potential vaccine candidate for further development.

Advanced fiber tracking in early acquired brain injury causing cerebral palsy.

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Lennartsson, F; Holmström, L; Eliasson, A-C; Flodmark, O; Forssberg, H; Tournier, J-D; Vollmer, B

2015-01-01

Diffusion-weighted MR imaging and fiber tractography can be used to investigate alterations in white matter tracts in patients with early acquired brain lesions and cerebral palsy. Most existing studies have used diffusion tensor tractography, which is limited in areas of complex fiber structures or pathologic processes. We explored a combined normalization and probabilistic fiber-tracking method for more realistic fiber tractography in this patient group. This cross-sectional study included 17 children with unilateral cerebral palsy and 24 typically developing controls. DWI data were collected at 1.5T (45 directions, b=1000 s/mm(2)). Regions of interest were defined on a study-specific fractional anisotropy template and mapped onto subjects for fiber tracking. Probabilistic fiber tracking of the corticospinal tract and thalamic projections to the somatosensory cortex was performed by using constrained spherical deconvolution. Tracts were qualitatively assessed, and DTI parameters were extracted close to and distant from lesions and compared between groups. The corticospinal tract and thalamic projections to the somatosensory cortex were realistically reconstructed in both groups. Structural changes to tracts were seen in the cerebral palsy group and included splits, dislocations, compaction of the tracts, or failure to delineate the tract and were associated with underlying pathology seen on conventional MR imaging. Comparisons of DTI parameters indicated primary and secondary neurodegeneration along the corticospinal tract. Corticospinal tract and thalamic projections to the somatosensory cortex showed dissimilarities in both structural changes and DTI parameters. Our proposed method offers a sensitive means to explore alterations in WM tracts to further understand pathophysiologic changes following early acquired brain injury. © 2015 by American Journal of Neuroradiology.

Congenital Toxoplasmosis: A Plea for a Neglected Disease.

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Wallon, Martine; Peyron, François

2018-02-23

Maternal infection by Toxoplasma gondii during pregnancy may have serious consequences for the fetus, ranging from miscarriage, central nervous system involvement, retinochoroiditis, or subclinical infection at birth with a risk of late onset of ocular diseases. As infection in pregnant women is usually symptomless, the diagnosis relies only on serological tests. Some countries like France and Austria have organized a regular serological testing of pregnant women, some others have no prenatal program of surveillance. Reasons for these discrepant attitudes are many and debatable. Among them are the efficacy of antenatal treatment and cost-effectiveness of such a program. A significant body of data demonstrated that rapid onset of treatment after maternal infection reduces the risk and severity of fetal infection. Recent cost-effectiveness studies support regular screening. This lack of consensus put both pregnant women and care providers in a difficult situation. Another reason why congenital toxoplasmosis is disregarded in some countries is the lack of precise information about its impact on the population. Precise estimations on the burden of the disease can be achieved by systematic screening that will avoid bias or underreporting of cases and provide a clear view of its outcome.

Congenital Toxoplasmosis: A Plea for a Neglected Disease

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Martine Wallon

2018-02-01

Full Text Available Maternal infection by Toxoplasma gondii during pregnancy may have serious consequences for the fetus, ranging from miscarriage, central nervous system involvement, retinochoroiditis, or subclinical infection at birth with a risk of late onset of ocular diseases. As infection in pregnant women is usually symptomless, the diagnosis relies only on serological tests. Some countries like France and Austria have organized a regular serological testing of pregnant women, some others have no prenatal program of surveillance. Reasons for these discrepant attitudes are many and debatable. Among them are the efficacy of antenatal treatment and cost-effectiveness of such a program. A significant body of data demonstrated that rapid onset of treatment after maternal infection reduces the risk and severity of fetal infection. Recent cost-effectiveness studies support regular screening. This lack of consensus put both pregnant women and care providers in a difficult situation. Another reason why congenital toxoplasmosis is disregarded in some countries is the lack of precise information about its impact on the population. Precise estimations on the burden of the disease can be achieved by systematic screening that will avoid bias or underreporting of cases and provide a clear view of its outcome.

Community-acquired pneumonia: 2012 history, mythology, and science.

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Donowitz, Gerald R

2013-01-01

Pneumonia remains one of the major disease entities practicing physicians must manage. It is a leading cause of infection-related morbidity and mortality in all age groups, and a leading cause of death in those older than 65 years of age. Despite its frequency and importance, clinical questions have remained in the therapy of community-acquired pneumonia including when to start antibiotics, when to stop them, who to treat, and what agents to use. Answers to these questions have involved historical practice, mythology, and science-sometimes good science, and sometimes better science. How clinical decisions are made for patients with community-acquired pneumonia serves as an illustrative model for other problem areas of medicine and allows for insight as to how clinical decisions have been made and clinical practice established.

Use of IgG in oral fluid to monitor infants with suspected congenital toxoplasmosis.

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Chapey, Emmanuelle; Meroni, Valeria; Kieffer, François; Bollani, Lina; Ecochard, René; Garcia, Patricia; Wallon, Martine; Peyron, François

2015-04-01

Infants born to mothers who seroconverted for toxoplasmosis during pregnancy are at risk of sequelae. In the case of a negative work-up at birth, congenital infection can be ruled out only by monitoring the disappearance of maternal immunoglobulin G (IgG) transmitted through the placenta, which can be achieved by regular blood sampling during the first year. To alleviate the discomfort of this follow-up, we developed an indirect enzyme-linked immunosorbent assay to detect specific IgG diffusing passively from the blood through the gingival epithelium by collecting oral fluid on microsponges. To assess the feasibility of the test, 212 patients were first enrolled. Levels of specific IgG in oral fluid were significantly higher in seropositive (n = 195) than in seronegative (n = 17) patients (mean optical densities, 1.145 ± 0.99 versus 0.092 ± 0.127; P < 0.0001). In a population of 93 patients <15 months of age born to mothers who displayed toxoplasmic infection during pregnancy, 70 were free of congenital infection and were followed up until their serology turned negative, and 23 were congenitally infected. The same patterns of IgG were observed in the oral fluid and sera in each group. Using a cutoff of 0.04 (optical density value), the sensitivity and specificity of the test were 67.9% and 80.3%, respectively, and the probability of not having a congenital infection when the test on oral fluid was negative was 99%. Although the performance of the test needs to be improved, oral fluid sampling appears to be a promising tool for monitoring infants with suspected congenital toxoplasmosis. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Inflammatory early events associated to the role of P2X7 receptor in acute murine toxoplasmosis.

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Corrêa, Gladys; Almeida Lindenberg, Carolina de; Moreira-Souza, Aline Cristina de Abreu; Savio, Luiz Eduardo Baggio; Takiya, Christina Maeda; Marques-da-Silva, Camila; Vommaro, Rossiane Claudia; Coutinho-Silva, Robson

2017-04-01

Activation of the purinergic P2X7 receptor by extracellular ATP (eATP) potentiates proinflammatory responses during infections by intracellular pathogens. Extracellular ATP triggers an antimicrobial response in macrophages infected with Toxoplasma gondii in vitro, suggesting that purinergic signaling may stimulate host defense mechanisms against toxoplasmosis. Here, we provide in vivo evidence in support of this hypothesis, by showing that P2X7 -/- mice are more susceptible than P2X7 +/+ mice to acute infection by the RH strain of T. gondii, and that this phenomenon is associated with a deficient proinflammatory response. Four days post-infection, peritoneal washes from infected P2X7 -/- mice had no or little increase in the levels of the proinflammatory cytokines IL-12, IL-1β, IFN-γ, and TNF-α, whose levels increased markedly in samples from infected P2X7 +/+ mice. Infected P2X7 -/- mice displayed an increase in organ weight and histological alterations in some of the 'shock organs' in toxoplasmosis - the liver, spleen and mesenteric lymph nodes. The liver of infected P2X7 -/- mice had smaller granulomas, but increased parasite load/granuloma. Our results confirm that the P2X7 receptor is involved in containing T. gondii spread in vivo, by stimulating inflammation. Copyright © 2016 Elsevier GmbH. All rights reserved.

Differentiation of thrombus from pannus as the cause of acquired mechanical prosthetic heart valve obstruction by non-invasive imaging: a review of the literature.

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Tanis, Wilco; Habets, Jesse; van den Brink, Renee B A; Symersky, Petr; Budde, Ricardo P J; Chamuleau, Steven A J

2014-02-01

For acquired mechanical prosthetic heart valve (PHV) obstruction and suspicion on thrombosis, recently updated European Society of Cardiology guidelines advocate the confirmation of thrombus by transthoracic echocardiography, transesophageal echocardiography (TEE), and fluoroscopy. However, no evidence-based diagnostic algorithm is available for correct thrombus detection, although this is clinically important as fibrinolysis is contraindicated in non-thrombotic obstruction (isolated pannus). Here, we performed a review of the literature in order to propose a diagnostic algorithm. We performed a systematic search in Pubmed and Embase. Included publications were assessed on methodological quality based on the validated Quality Assessment of Diagnostic Accuracy Studies (QUADAS) II checklist. Studies were scarce (n = 15) and the majority were of moderate methodological quality. In total, 238 mechanical PHV's with acquired obstruction and a reliable reference standard were included for the evaluation of the role of fluoroscopy, echocardiography, or multidetector-row computed tomography (MDCT). In acquired PHV obstruction caused by thrombosis, mass detection by TEE and leaflet restriction detected by fluoroscopy were observed in the majority of cases (96 and 100%, respectively). In contrast, in acquired PHV obstruction free of thrombosis (pannus), leaflet restriction detected by fluoroscopy was absent in some cases (17%) and mass detection by TEE was absent in the majority of cases (66%). In case of mass detection by TEE, predictors for obstructive thrombus masses (compared with pannus masses) were leaflet restriction, soft echo density, and increased mass length. In situations of inconclusive echocardiography, MDCT may correctly detect pannus/thrombus based on the morphological aspects and localization. In acquired mechanical PHV obstruction without leaflet restriction and absent mass on TEE, obstructive PHV thrombosis cannot be confirmed and consequently, fibrinolysis

Levantamento soroepidemiológico da frequência de Toxoplasma gondii em doadores de córnea do Banco de Olhos de Volta Redonda, RJ, Brasil

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Mariana Gleice Seabra

2016-11-01

Full Text Available ABSTRACT. Seabra M.G., Aleixo A.L.Q. do C., Pereira P.F., Pinheiro J., Amendoeira M.R.R. [Levantamento soroepidemiológico da frequência de Toxoplasma gondii em doadores de córnea do Banco de Olhos de Volta Redonda, RJ, Brasil] A seroepidemiological survey of the frequency of Toxoplasma gondii in corneal donors from Volta Redonda eye bank . Revista Brasileira de Medicina Veterinária, 38(supl. 3:229-239, 2016. Programa de Pós-graduação em Ciências Veterinárias, Instituto de Veterinária, Universidade Federal Rural do Rio de Janeiro, BR 465, km 7, Campus Seropédica 23897-970, Seropédica, RJ, Brazil. E-mail: jairopinheirodasilva@gmail.com Toxoplasma gondii is a protozoan parasite that infects up to a third of the world's population. Infection is mainly acquired by ingestion of food or water that is contaminated with oocysts shed by cats or by eating undercooked or raw meat containing tissue cysts and by blood transfusion or organ transplantation. Primary infection is usually subclinical but in some patients cervical lymphadenopathy or ocular disease can be present. Infection acquired during pregnancy may cause severe damage to the fetus. In immunocompromised patients, reactivation of latent disease can cause life-threatening encephalitis. Diagnosis of toxoplasmosis can be established by direct detection of the parasite or by serological techniques. The aim of the present study was verify the seroprevalence of toxoplasmosis in cornea donors of Rio de Janeiro, Brazil. IgM and IgG anti- T. gondii antibodies were investigated in 426 sera of corneal donors by using the indirect fluorescent antibody test (IFAT and immunoenzymatic assay (ELISA techniques. The participants were selected by convenience sampling. Demographic information of study subjects including their gender, age, cause of death and home region were recorded. Out of 426 serum samples, 338 (79.34% and 17 (3.99% were positive regarding anti-T. gondii IgG and IgM antibodies ELISA

Actualidades en el tratamiento y profilaxis de la toxoplasmosis

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Manuela de la Caridad Valdés Abreu

1996-08-01

Full Text Available Se ofrece una revisión teórica actualizada sobre la terapia, la prevención y el control de la toxoplasmosis a partir de la literatura revisada en las bases de datos MEDLINE, LILACS y la de Literatura Cubana de Medicina de los años 1989 a 1995, también se incluyen algunos clásicos propios de la temática localizados en los órganos de información del Sistema Nacional de Información de Ciencias Médicas. Se tratan otros aspectos de interés como el modo de transmisión, los hospederos (definitivos e intermediarios y las manifestaciones clínicas más notables. Se destaca la importancia de realizar el examen parasitológico a nivel primario de salud y con carácter masivo a partir del proceso de captación de la embarazada y de llevar a cabo el seguimiento, con vistas a detectar tempranamente la presencia del parásito o la enfermedad y evitar las consecuencias negativas que esta conlleva.

TOXOPLASMOSIS IN MEXICO: EPIDEMIOLOGICAL SITUATION IN HUMANS AND ANIMALS

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Ivonne HERNÁNDEZ-CORTAZAR

2015-04-01

Full Text Available Toxoplasmosis is a parasitic disease widely distributed throughout the world, infecting a wide variety of animal species including humans. In Mexico, this parasite has been detected in different parts of the country, particularly in the tropical areas where the parasite can remain infective for long periods of time due to the environmental conditions (i.e. high temperature and humidity over the whole year. Several epidemiological studies have been conducted in both human and animal populations, but despite the wide distribution of the agent in the country, there is a significant lack of knowledge on the parasite transmission, treatment alternatives and control measures. The lack of feral cat populations and control measures in sites of meat production for human consumption are playing a role that has led to the wide spread of the disease in the country, particularly in tropical areas of Southeastern Mexico. For these reasons, this manuscript aims to review the published information on relevant epidemiological aspects of infection with T. gondii in humans and animals from Mexico.

Toksoplasmose-chorioretinitis: klinisk forløb og behandling af syv patienter

DEFF Research Database (Denmark)

Lebech, A M; Lebech, M; Børme, K K

1996-01-01

Toxoplasmosis is a major and preventable cause of severe visual loss and blindness in young people. Ocular toxoplasmosis is the leading cause of posterior uveitis and in most cases it represents a late manifestation of a congenital infection. The clinical picture and anti-Toxoplasma therapy...... are demonstrated and there is no other diagnosis, anti-Toxoplasma treatment should be considered. It is important to inform pregnant women about prophylactic measures, and to perform a serological screening of newborns, since treatment of congenital toxoplasmosis from birth improves the prognosis....

Novel pharmacotherapy for the treatment of hospital-acquired and ventilator-associated pneumonia caused by resistant gram-negative bacteria.

Science.gov (United States)

Kidd, James M; Kuti, Joseph L; Nicolau, David P

2018-03-01

Hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP) are among the most prevalent infections in hospitalized patients, particularly those in the intensive care unit. Importantly, the frequency of multidrug resistant (MDR) Gram-negative (GN) bacteria as the bacteriologic cause of HABP/VABP is increasing. These include MDR Pseudomonas aeruginosa, Acinetobacter baumannii, and carbapenem resistant Enterobacteriaceae (CRE). Few antibiotics are currently available when such MDR Gram-negatives are encountered and older agents such as polymyxin B, colistin (polymyxin E), and tigecycline have typically performed poorly in HABP/VABP. Areas covered: In this review, the authors summarize novel antibiotics which have reached phase 3 clinical trials including patients with HABP/VABP. For each agent, the spectrum of activity, pertinent pharmacological characteristics, clinical trial data, and potential utility in the treatment of MDR-GN HABP/VABP is discussed. Expert opinion: Novel antibiotics currently available, and those soon to be, will expand opportunities to treat HABP/VABP caused by MDR-GN organisms and minimize the use of more toxic, less effective drugs. However, with sparse clinical data available, defining the appropriate role for each of the new agents is challenging. In order to maximize the utility of these antibiotics, combination therapy and the role of therapeutic drug monitoring should be investigated.

Community-acquired pneumonia in older patients: does age influence systemic cytokine levels in community-acquired pneumonia?

LENUS (Irish Health Repository)

Kelly, Emer

2009-03-01

Community-acquired pneumonia (CAP) is a major cause of death in the elderly. The age-related increase in comorbid illnesses plays a part but the effect of aging on the immune response may be equally important. We aimed to evaluate patients with CAP for evidence of a muted response to infection in elderly patients admitted to hospital compared with a younger patient group.

A case of acquired port wine stain: an association with repeated sunburn?

Science.gov (United States)

Seremet, Sila; Benar, Elif B; Afsar, Fatma Sule; Calli, Aylin; Ulusarac, Ozlem

2016-10-01

Unlike congenital port wine stain (PWS), an acquired PWS is a rare vascular lesion that develops later in life. Although solar damage is associated with acquired PWS, there is no reported case of acquired PWS after sunburn in the literature. We report a case of a 54-year-old man diagnosed with acquired PWS possibly caused by repeated sunburn. We recommended laser treatment to our patient; however, the patient did not chose to receive any treatment. Our case demonstrates a possible rare occurrence of an acquired PWS after sunburn with larger lesions and more diffuse distribution. For this reason, our case differs from other acquired PWS cases. © 2016 The International Society of Dermatology.

The design of a Social Cost-Benefit Analysis of preventive interventions for toxoplasmosis: An example of the One Health approach.

Science.gov (United States)

Suijkerbuijk, A W M; van Gils, P F; Bonačić Marinović, A A; Feenstra, T L; Kortbeek, L M; Mangen, M-J J; Opsteegh, M; de Wit, G A; van der Giessen, J W B

2018-02-01

Toxoplasma gondii infections cause a large disease burden in the Netherlands, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. Infections in humans occur via exposure to oocysts in the environment and after eating undercooked meat containing tissue cysts, leading to asymptomatic or mild symptoms, but potentially leading to the development of ocular toxoplasmosis. Infection in pregnant women can lead to stillbirth and disorders in newborns. At present, prevention is only targeted at pregnant women. Cat vaccination, freezing of meat destined for undercooked consumption and enhancing biosecurity in pig husbandries are possible interventions to prevent toxoplasmosis. As these interventions bear costs for sectors in society that differ from those profiting from the benefits, we perform a social cost-benefit analysis (SCBA). In an SCBA, costs and benefits of societal domains affected by the interventions are identified, making explicit which stakeholder pays and who benefits. Using an epidemiological model, we consider transmission of T. gondii after vaccination of all owned cats or cats at livestock farms. To identify relevant high-risk meat products that will be eaten undercooked, a quantitative microbial risk assessment model developed to attribute predicted T. gondii infections to specific meat products will be used. In addition, we evaluate serological monitoring of pigs at slaughter followed by an audit and tailor made advice for farmers in case positive results were found. The benefits will be modelled stochastically as reduction in DALYs and monetized in Euro's following reference prices for DALYs. If the balance of total costs and benefits is positive, this will lend support to implementation of these preventive interventions at the societal level. Ultimately, the SCBA will provide guidance to policy makers on the most optimal intervention measures to reduce the disease burden of T

MR imaging of white matter lesions in AIDS

International Nuclear Information System (INIS)

Olsen, W.L.; Longo, F.; Norman, D.

1987-01-01

Autopsy reports have shown white-matter abnormalities from infection of the brain by the human immunodeficiency virus (HIV), the agent that causes acquired immunodeficiency syndrome (AIDS). The authors observed abnormal signal on T2-weighted images in the white matter of approximately one third of all AIDS patients. Of 50 patients with white-matter lesions, approximately two thirds had no clinical or biopsy evidence of cytomegalovirus, toxoplasmosis, PML, or lymphoma. Several patients were shown at autopsy to have isolated evidence of HIV encephalitis. The authors conclude that white-matter lesions are common in AIDS and are frequently caused by infection with HIV. Some MR findings may be helpful in characterizing these lesions, but the various etiologies are often indistinguishable

Epidemiology of toxoplasmosis in white tailed deer (Odocoileus virginianus): occurrence, congenital transmission, correlates of infection, isolation, and genetic characterization of Toxoplasma gondii

Science.gov (United States)

The prevalence of Toxoplasma gondii in white tailed deer (WTD) in the USA is high, but little is known of the epidemiology of toxoplasmosis in this host. In the present study, we compared T. gondii seroprevalence from 531 WTD collected in 2012 and 2013 from a Metropolitan Park in Ohio, and and 485 W...

Comparison of Mother and Child Antibodies That Target High-Molecular-Mass Toxoplasma gondii Antigens by Immunoblotting Improves Neonatal Diagnosis of Congenital Toxoplasmosis

Science.gov (United States)

Wallon, Martine; Faucher, Benoit; Piarroux, Renaud; Peyron, François; Franck, Jacqueline

2012-01-01

This retrospective study proposes a new reading of immunoblotting (IB) in the diagnosis of congenital toxoplasmosis. Our findings demonstrate that a three-IgM-band association at 75, 90, and 100 kDa called the IgM triplet increases the sensitivity to 95.8% when combined with prenatal and serological neonatal tests. PMID:22695159

Toxoplasmose ocular em cães jovens inoculados com Toxoplasma gondii Ocular toxoplasmosis in young dogs inoculated with Toxoplasma gondii

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Cláudia Bonini de Abreu

2002-10-01

papilledema, peripapillary exsudate and tapetum pigmentation were noted in three dogs submitted to retinograph. The histopathology showed focal mononuclear infiltrate of choroid, congestion of chorioretinal vessels an subretinal edema in eight dogs. Our results allow to conclude that acquired ocular toxoplasmosis in the dogs is as significant as in man and in doing so other studies must be undertaken.

Cuban Ocular Toxoplasmosis Epidemiology Study (COTES): incidence and prevalence of ocular toxoplasmosis in Central Cuba.

Science.gov (United States)

Bustillo, Jorge L; Diaz, Jose D; Pacheco, Idarmes C; Gritz, David C

2015-03-01

Serological studies indicate that rates of ocular toxoplasmosis (OT) vary geographically, with higher rates in tropical regions. Little is known about population-based rates of active OT. We aimed to describe the epidemiology of OT in Central Cuba. This large-population, cross-sectional cohort study used a prospective database at a large regional referral centre in Central Cuba. The patient database was searched for all patients who presented with OT during the 12-month study period from 1 April 2011 to 31 March 2012. Inclusion criteria were the clinical diagnosis of OT, characterised by focal retinochoroidal inflammation and a response to therapy as expected. Gender-stratified and age-stratified study population data from the 2012 Cuban Census were used to calculate incidence rates and prevalence ratios. Among 279 identified patients with OT, 158 presented with active OT. Of these, 122 new-onset and 36 prior-onset cases were confirmed. Based on the total population in the Sancti Spiritus province (466,106 persons), the overall incidence of active OT was 26.2 per 100,000 person-years (95% CI 21.7 to 31.3) with an annual prevalence ratio of 33.9 per 100,000 persons (95% CI 28.8 to 39.6). The incidence of active OT was lowest in the oldest age group and highest in patients aged 25-44 years (4.5 and 42.1 per 100,000 person-years, respectively). This first report describing population-based rates of OT in the Cuban population highlights the importance of patient age as a likely risk factor for OT. Disease rates were found to be highest in females and young to middle-aged adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Estudo transversal de toxoplasmose em alunas de um curso superior da região de Presidente Prudente, Estado de São Paulo Cross-sectional study on toxoplasmosis among female students on a university course in the Presidente Prudente region, State of São Paulo

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Cristiane de Oliveira Souza

2010-02-01

Full Text Available INTRODUÇÃO: toxoplasmose é uma doença parasitária causada pelo protozoário Toxoplasma gondii, que acomete o homem e outros animais. A forma mais grave é a toxoplasmose congênita, sendo então importante estabelecer o perfil sorológico da mulher antes da gestação. Este trabalho objetivou analisar a sorologia para toxoplasmose de alunas do curso de Enfermagem da UNOESTE (Universidade do Oeste Paulista Presidente Prudente/SP. MÉTODOS: foram coletadas amostras de sangue de 80 alunas, com idade de 18 a 35 anos após assinatura do Termo de Consentimento. A ocorrência de anticorpos IgM e IgG anti-Toxoplasma gondii foi determinada pelo método ELISA. Este trabalho foi aprovado pelo Comitê de Ética da Instituição e realizado no Laboratório de Imunologia da UNOESTE. RESULTADOS: das 80 amostras de sangue analisadas, 27 alunas apresentaram IgG positiva e nenhuma apresentou anticorpo IgM. CONCLUSÕES: das 80 alunas, 53 (66,2%, são suscetíveis à toxoplasmose numa possível gestação. Sendo 27 (33,8 as alunas consideradas soropositivas.INTRODUCTION: Toxoplasmosis is a parasitic disease caused by the protozoan Toxoplasma gondii, which affects humans and other animals. The most severe form is congenital toxoplasmosis. Thus, it is important to establish the serological profile of women before pregnancy. This study aimed to analyze the serology of toxoplasmosis among female students on the nursing course at Unoeste (Universidade do Oeste Paulista, in Presidente Prudente, SP. METHODS: Blood samples were collected from 80 female students aged 18 to 35 years after they had signed the consent statement. Occurrences of anti-Toxoplasma gondii IgM and IgG antibodies were determined using the ELISA method. This study was approved by the institution's ethics committee and was conducted in the Immunology Laboratory at Unoeste. RESULTS: Among the 80 blood samples analyzed, 27 female students were positive for IgG, whereas none of them were positive for

The comparative development of elevated resistance to macrolides in community-acquired pneumonia caused by Streptococcus pneumoniae

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Yayan J

2014-10-01

Full Text Available Josef Yayan Department of Internal Medicine, Division of Pulmonary, Allergy and Sleep Medicine, Saarland University Medical Center, Homburg/Saar, Germany Background: Community-acquired pneumonia (CAP is an acute inflammation of the lungs, which is often caused by Streptococcus pneumoniae. CAP is the leading cause of death by infectious disease in industrialized countries. Therefore, an immediate and effective antibiotic therapy is of great importance for the nonfatal outcome of the disease. The literature contains increasing data about the development of resistance to antibiotics that are used for the treatment of CAP caused by S. pneumoniae; this article also examines the possible development of resistance to antibiotics in S. pneumoniae in recent years.Methods: Within the study period of 2004–2014, all hospital charts from patients with CAP caused by S. pneumoniae were collected from the Department of Internal Medicine, Saarland University Medical Center, Homburg/Saar, Germany. The tracheal secretions of S. pneumoniae in CAP patients were obtained by bronchoalveolar lavage; bronchial aspirates were obtained through flexible bronchoscopy and directly from sputum, and blood cultures were examined microbiologically for microorganisms.Results: From a total of 100 patients with CAP caused by S. pneumoniae, 23 (53.49% [34.78% female], 95% confidence interval, 38.58–68.4 patients with a mean age of 59.78±15.77 years met the inclusion criteria of this investigation. These patients were compared to a total of 20 (46.51% [35% female], 95% confidence interval, 31.6–61.42 patients with a mean age of 58.9±13.36 years with CAP who were infested with S. pneumoniae. In the latter group, the streptococcal antigen was detected in pulmonary aspirations by bronchoscopy or in urine using polymerase chain reaction and a rapid pneumococcal test. Penicillin G and vancomycin had a high rate of sensitivity on the antibiogram for S. pneumoniae, which was

Bacterial Isolates andAntibiotic Sensitivity in Community Acquired ...

African Journals Online (AJOL)

Objective: The objective of the studywas to determine bacterial causes of community acquired pneumonia and their antibiotic sensitivity pattern amongst patients admitted intomedicalwards inAminu Kano Teaching Hospital, Kano, Nigeria Methods: The study incorporated patients aged fifteen years and above admitted into ...

Ante-mortem diagnosis, diarrhea, oocyst shedding, treatment, isolation, and genetic typing of Toxoplasma gondii associated with clinical toxoplasmosis in a naturally infected cat.

Science.gov (United States)

Dubey, J P; Prowell, M

2013-02-01

Toxoplasma gondii infections are common in humans and other animals, but clinical disease is relatively rare. It is unknown whether the severity of toxoplasmosis in immunocompetent hosts is due to the parasite strain, host variability, or to other factors. Recently, attention has been focused on the genetic variability among T. gondii isolates from apparently healthy and sick hosts. Whether T. gondii genetic makeup plays a part in the pathogenesis of clinical feline toxoplasmosis is uncertain because little is known of genetic typing of strains associated with clinical feline toxoplasmosis. A 6-mo-old domestic male cat was hospitalized because of lethargy, anorexia, fever, and diarrhea. Numerous (6 million in 1 sample) T. gondii oocysts were found in feces of the cat and antibodies to T. gondii (titer 1:800) were found in its serum by the modified agglutination test. The cat was medicated orally with Clindamycin for 10 days; it became asymptomatic after 10 days and was discharged from the hospital. Viable T. gondii (designated TgCatUs9) was isolated from feces (oocysts) by bioassays in mice. Genetic typing using the DNA extracted from the brains of infected mice and 10 PCR-restriction fragment length polymorphism (RFLP) markers revealed Type II allele at the SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, and PK1 loci and Type I at the L358 and Apico loci; therefore, this isolate belongs to the ToxoDB PCR-RFLP genotype no. 4, which is grouped into the Type 12 lineage that is dominant in wildlife from North America. To our knowledge, this is the first T. gondii isolate characterized genetically from a sick cat in the USA.

Botulinum toxin in the management of sialorrhoea in acquired brain injury

LENUS (Irish Health Repository)

Carroll, A

2016-06-01

Sialorrhoea as a consequence of severe acquired brain injury can significantly negatively impact on quality of life. Medications used in its management have many side effects which can cause problems in the severely disabled. Botulinum toxin is an effective treatment of sialorrhoea in a number of neurological conditions but may also have a role to play in the management of sialorrhoea following severe ABI. We report on 4 cases of sialorrhoea following acquired brain injury causing a variety of problems, whose parotid glands were injected with Botulinum toxin type A (Dysport) 50mu each, under ultrasound guidance. All cases had a clinically and statistically significant reduction in drooling as measured by the teacher drooling scale (p=0.005) and carers Visual Analogue Scale (p=0.012). There were no side effects reported. Botulinum toxin is an effective treatment for sialorrhoea associated with acquired brain injury.

Neuropathological Changes and Clinical Features of Autism Spectrum Disorder Participants Are Similar to that Reported in Congenital and Chronic Cerebral Toxoplasmosis in Humans and Mice

Science.gov (United States)

Prandota, Joseph

2010-01-01

Anatomic, histopathologic, and MRI/SPET studies of autistic spectrum disorders (ASD) patients' brains confirm existence of very early developmental deficits. In congenital and chronic murine toxoplasmosis several cerebral anomalies also have been reported, and worldwide, approximately two billion people are chronically infected with T. "gondii"…

A new human IgG avidity test, using mixtures of recombinant antigens (rROP1, rSAG2, rGRA6), for the diagnosis of difficult-to-identify phases of toxoplasmosis.

Science.gov (United States)

Drapała, Dorota; Holec-Gąsior, Lucyna; Kur, Józef; Ferra, Bartłomiej; Hiszczyńska-Sawicka, Elżbieta; Lautenbach, Dariusz

2014-07-01

The preliminary diagnostic utility of two mixtures of Toxoplasma gondii recombinant antigens (rROP1+rSAG2 and rROP1+rGRA6) in IgG ELISA and IgG avidity test has been evaluated. A total of 173 serum samples from patients with toxoplasmosis and seronegative people were examined. The sensitivity of IgG ELISA for rROP1+rSAG2 and rROP1+rGRA6 was 91.1% and 76.7%, respectively, while the reactivity for sera from patients where acute toxoplasmosis was suspected was higher, at 100% and 95.4%, respectively, than for people with chronic infection, at 88.2% and 70.6%. In this study a different trend in avidity maturation of IgG antibodies for two mixtures of proteins in comparison with native antigen was observed. The results suggest that a new IgG avidity test using the mixtures of recombinant antigens may be useful for the diagnosis of difficult-to-identify phases of toxoplasmosis. For this reason, selected mixtures after the additional tests on groups of sera with well-defined dates of infection could be used as a better alternative to the native antigens of the parasite in the serodiagnosis of human T. gondii infection. Copyright © 2014 Elsevier Inc. All rights reserved.

Community-acquired pneumonia - a clinical approach to ...

African Journals Online (AJOL)

to pneumonia acquired within the general community. CAP remains a common and ... patients.2 The exact incidence of atypical pathogens as a cause of CAP in South Africa is ... nor specific enough to use in clinical practice. There is a ..... resolve within 14 days but non-respiratory symptoms such as fatigue may persist for ...

Determination of the viability of Toxoplasma gondii in cured ham using bioassay: influence of technological processing and food safety implications.

Science.gov (United States)

Bayarri, Susana; Gracia, María J; Lázaro, Regina; Pe Rez-Arquillué, Consuelo; Barberán, Montserrat; Herrera, Antonio

2010-12-01

Toxoplasmosis is a zoonotic disease caused by the protozoan Toxoplasma gondii and distributed worldwide. Ingestion of viable cysts from infected raw or undercooked meat is an important route of horizontal transmission of the parasite to humans. Little information is available concerning the effect of commercial curing on cysts of T. gondii. This study is the first in which the influence of processing of cured ham on the viability of T. gondii has been evaluated, using bioassay to assess the risk of infection from eating this meat product. Naturally infected pigs were selected for the study, and a mouse concentration bioassay technique was used to demonstrate viable bradyzoites of T. gondii in porcine tissues and hams. No viable parasites were found in the final product (14 months of curing) based on results of the indirect immunofluorescence assay and histological and PCR analyses. Our results indicate that the consumption of hams cured as described here poses an insignificant risk of acquiring toxoplasmosis. However, additional studies are required to evaluate the safety of ham products cured under different conditions of curing time, salt, and nitrite concentration.

Community-acquired acute kidney injury in adults in Africa.

Science.gov (United States)

Adu, Dwomoa; Okyere, Perditer; Boima, Vincent; Matekole, Michael; Osafo, Charlotte

We review recent published data on demographics, causes, diagnoses, treatment, and outcome of acute kidney injury (AKI) in Africa. A review of the incidence, etiology, diagnoses, and treatment of AKI in adults in Africa from studies published between the years 2000 and 2015. The incidence of AKI in hospitalized patients in Africa ranges from 0.3 to 1.9% in adults. Between 70 and 90% of cases of AKI are community acquired. Most patients with AKI are young with a weighted mean age of 41.3 standard deviation (SD) 9.3 years, and a male to female ratio of 1.2 : 1.0. Medical causes account for between 65 and 80% of causes of AKI. This is followed by obstetric causes in 5 - 27% of cases and surgical causes in 2 - 24% of cases. In the reported studies, between 17 and 94% of patients who needed dialysis received this. The mortality of AKI in adults in Africa ranged from 11.5 to 43.5%. Most reported cases of AKI in Africa originate in the community. The low incidence of hospital-acquired AKI is likely to be due to under ascertainment. Most patients with AKI in Africa are young and have a single precipitating cause. Prominent among these are infection, pregnancy complications and nephrotoxins. Early treatment can improve clinical outcomes.

Epidemiology, Management, and Risk-Adjusted Mortality of ICU-Acquired Enterococcal Bacteremia

NARCIS (Netherlands)

Ong, David S Y; Bonten, Marc J M; Safdari, Khatera; Spitoni, Cristian; Frencken, Jos F; Witteveen, Esther; Horn, Janneke; Klein Klouwenberg, Peter M C; Cremer, Olaf L

2015-01-01

BACKGROUND:  Enterococcal bacteremia has been associated with high case fatality, but it remains unknown to what extent death is caused by these infections. We therefore quantified attributable mortality of intensive care unit (ICU)-acquired bacteremia caused by enterococci. METHODS:  From 2011 to

Diagnosis and Treatment of Community-Acquired Pneumonia in Children

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I.A. Karymdzhanov

2016-02-01

The initial antibiotic therapy of community-acquired pneumonia is carried out empirically. In the treatment of severe community-acquired pneumonia in children from 2 months to 5 years, the drug of choice is amoxicillin orally. Macrolides are the drugs of choice for children aged 5 to 16 years. In severe pneumonia, drugs of choice are amoxicillin clavulanate, 2nd–4th generation cephalosporins. In general, the duration of antibiotic therapy in the community-acquired pneumonia caused by typical bacteria is 7–10 days, by atypical bacteria — 10–14 days. In the real clinical practice, the errors associated with the choice of drug, route of administration, dosage, regimen of application, length of treatment are frequent during antibacterial therapy.

Advantages of bioconjugated silica-coated nanoparticles as an innovative diagnosis for human toxoplasmosis.

Science.gov (United States)

Aly, Ibrahim; Taher, Eman E; El Nain, Gehan; El Sayed, Hoda; Mohammed, Faten A; Hamad, Rabab S; Bayoumy, Elsayed M

2018-01-01

Nanotechnology is a promising arena for generating new applications in Medicine. To successfully functionalised nanoparticles for a given biomedical application, a wide range of chemical, physical and biological factors have to be taken into account. Silica-coated nanoparticles, (SiO2NP) exhibit substantial diagnostic activity owing to their large surface to volume ratios and crystallographic surface structure. This work aimed to evaluate the advantage of bioconjugation of SiO2NP with PAb against Toxoplasma lyzate antigen (TLA) as an innovative diagnostic method for human toxoplasmosis. This cross-sectional study included 120 individuals, divided into Group I: 70 patients suspected for Toxoplasma gondii based on the presence of clinical manifestation. Group II: 30 patients harboring other parasites than T. gondii Group III: 20 apparently healthy individuals free from toxoplasmosis and other parasitic infections served as negative control. Detection of circulating Toxoplasma antigen was performed by Sandwich ELISA and Nano-sandwich ELISA on sera and pooled urine of human samples. Using Sandwich ELISA, 10 out of 70 suspected Toxoplasma-infected human serum samples showed false negative and 8 out of 30 of other parasites groups were false positive giving 85.7% sensitivity and 84.0% specificity, while the sensitivity and specificity were 78.6% and 70% respectively in urine samples. Using Nano-Sandwich ELISA, 7 out of 70 suspected Toxoplasma-infected human samples showed false negative results and the sensitivity of the assay was 90.0%, while 4 out of 30 of other parasites groups were false positive giving 92.0% specificity, while the sensitivity and specificity were 82.6% and 80% respectively in urine samples. In conclusion, our data demonstrated that loading SiO2 nanoparticles with pAb increased the sensitivity and specificity of Nano-sandwich ELISA for detection of T.gondii antigens in serum and urine samples, thus active (early) and light infections could be easily

[Toxoplasmosis, a parasitic zoonoses prevalent in Chile: count and challenges].

Science.gov (United States)

Mimica, Francisco; Muñoz-Zanzi, Claudia; Torres, Marisa; Padilla, Oslando

2015-10-01

Toxoplasmosis, cosmopolitan parasitic zoonosis often found in humans, is transmitted mainly by food and water, and is considered a significant risk of morbidity and mortality in pregnant women, newborns and immunocompromised patients. To identify the information about this zoonosis and its first reports in Chile. Review of publications in Pubmed, Mesh search of systematic reviews, case studies, cross-sectional studies, systematic reviews, meta-analysis and specialty publications. In addition, other publications in parasitology journals were analyzed. There are reports of the presence of this disease in Chile for 60 years. During this time several differences in prevalence depending on geographic location, age and education level of the population have been detected. There is low epidemiological vigilance and lack of specific official preventive measures for this disease, despite the possible introduction of new parasite genotypes of an increased virulence and pathogenicity in the country through the importation of meat. New enigmas have arisen in relation to this disease associating it with Alzheimer, Parkinson's disease, autism, learning disabilities, among others.

Metabolic, Immune, Epigenetic, Endocrine and Phenotypic Abnormalities Found in Individuals with Autism Spectrum Disorders, Down Syndrome and Alzheimer Disease May Be Caused by Congenital and/or Acquired Chronic Cerebral Toxoplasmosis

Science.gov (United States)

Prandota, Joseph

2011-01-01

"Toxoplasma gondii" is a protozoan parasite that infects about a third of human population. It is generally believed that in immunocompetent hosts, the parasite infection takes usually asymptomatic course and induces self-limiting disease, but in immunocompromised individuals may cause significant morbidity and mortality. "T. gondii" uses sulfated…

Severe Community-acquired Pneumonia Due to Legionella pneumophila Serogroup 6

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Chung-Yu Chen

2006-01-01

Full Text Available Legionella pneumophila is a common cause of sporadic community-acquired pneumonia, but culture-proven legionellosis is rarely diagnosed. There is no laboratory test for Legionnaires' disease that can detect all patients with the disease. Culture is the standard diagnostic method and should be initiated as soon as possible in suspected cases. We describe a rare case of community-acquired pneumonia caused by L. pneumophila serogroup 6. A 77-year-old man was admitted to a tertiary care hospital because of high fever, productive cough, and progressive dyspnea. Chest radiography showed bilateral pneumonia, which led to respiratory failure necessitating mechanical ventilatory support. Despite antibiotic therapy, his condition continued to deteriorate and acute renal failure also developed. Urine was negative for L. pneumophila. Culture of the sputum yielded L. pneumophila serogroup 6, although there was no elevation of the serum antibody titer. Pneumonia resolved gradually and he was extubated after treatment with levofloxacin followed by erythromycin. L. pneumophila other than serogroup 1 should be included in the differential diagnosis of patients with suspected atypical community-acquired pneumonia.

Onychomycosis by Fusarium oxysporum probably acquired in utero

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Vania O. Carvalho

2014-10-01

Full Text Available Fusarium oxysporum has been described as a pathogen causing onychomycosis, its incidence has been increasing in immunocompetent and disseminated infection can occur in immunosuppressed individuals. We describe the first case of congenital onychomycosis in a child caused by Fusarium oxysporum. The infection being acquired in utero was proven by molecular methods with the identification of the fungus both in the nail and placenta, most probably as an ascending contamination/infection in a HIV-positive, immunosuppressed mother.

Causes of permanent childhood hearing impairment.

Science.gov (United States)

Korver, Anna M H; Admiraal, Ronald J C; Kant, Sarina G; Dekker, Friedo W; Wever, Capi C; Kunst, Henricus P M; Frijns, Johan H M; Oudesluys-Murphy, Anne Marie

2011-02-01

The causes of Permanent Childhood Hearing Impairment (PCHI) are often quoted as being hereditary in 50%, acquired in 25%, and unknown in 25% of cases. Interest in the causes of PCHI has grown recently due to increasing diagnostic possibilities. We investigated the evidence for the reported distribution of these causes. Population-based study and a systematic review. Inclusion criteria for population-based study: children born between 2003 and 2005, resident in The Netherlands at birth, known at an Audiology Center with PCHI at the age of 3-5 years. The causes of PCHI were determined prospectively by detection of congenital cytomegalovirus on dried blood spots and/or genetic diagnostic investigations in addition to reviewing data from medical records. A systematic review was carried out using three terms (hearing loss, infant, and etiology) and limited to articles published between January 1997 and July 2009. Main outcome measures were: the (weighted) proportions of the various causes of PCHI following diagnostic investigations. In the study-population (n = 185) a hereditary cause was found in 38.9%, acquired cause in 29.7%, miscellaneous cause in 7.1%, and the cause remained unknown in 24.3%. The systematic review of the literature (n = 9 articles) resulted in a weighted mean of 30.4% hereditary, 19.2% acquired, and 48.3% unknown causes of PCHI. The systematic review and the results of the population-based study provided little support for the generally accepted distribution of causes of PCHI. Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.

Salivary IgA against sporozoite-specific embryogenesis-related protein (TgERP) in the study of horizontally transmitted toxoplasmosis via T. gondii oocysts in endemic settings

Science.gov (United States)

The prevalence of toxoplasmosis was investigated in endemic settings in Brazil, and calculated by measuring antibodies in two ELISA systems: 1) IgG and IgM from sera tested by commercial conventional ELISA, and 2) IgA, from saliva, and IgG from sera samples tested against a sporozoite-specific prote...

Guiding therapy and adjunctive treatment in community-acquired pneumonia

NARCIS (Netherlands)

Spoorenberg, S.M.C.

2018-01-01

Background: Despite the availability of effective antibiotics and vaccines, community-acquired pneumonia (CAP) remains the cause of significant morbidity and mortality worldwide.A major problem is that in absence of full spectrum rapid microbiology diagnostics, the antibiotic treatment at start is

Everyday and Exotic Foodborne Parasites

Directory of Open Access Journals (Sweden)

Marilyn B Lee

2000-01-01

Full Text Available Everyday foodborne parasites, which are endemic in Canada, include the protozoans Entamoeba histolytica, Giardia lamblia and Cryptosporidium parvum. However, these parasites are most frequently acquired through unfiltered drinking water, homosexual activity or close personal contact such as in daycare centres and occasionally via a food vehicle. It is likely that many foodborne outbreaks from these protozoa go undetected. Transmission of helminth infections, such as tapeworms, is rare in Canada because of effective sewage treatment. However, a common foodborne parasite of significance is Toxoplasma gondii. Although infection can be acquired from accidental ingestion of oocysts from cat feces, infection can also result from consumption of tissue cysts in undercooked meat, such as pork or lamb. Congenital transmission poses an immense financial burden, costing Canada an estimated $240 million annually. Also of concern is toxoplasmosis in AIDS patients, which may lead to toxoplasmosis encephalitis, the second most common AIDS-related opportunistic infection of the central nervous system. Exotic parasites (ie, those acquired from abroad or from imported food are of growing concern because more Canadians are travelling and the number of Canada?s trading partners is increasing. Since 1996, over 3000 cases of Cyclospora infection reported in the United States and Canada were epidemiologically associated with importation of Guatemalan raspberries. Unlike toxoplasmosis, where strategies for control largely rest with individual practices, control of cyclosporiasis rests with government policy, which should prohibit the importation of foods at high risk.

The Importance of IgG Avidity and the Polymerase Chain Reaction in Treating Toxoplasmosis during Pregnancy: Current Knowledge

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João Bortoletti Filho

2013-01-01

Full Text Available A brief report on the nature and epidemiology of T. gondii infection is firstly presented. The importance of the specific IgG avidity test and polymerase chain reaction (PCR for toxoplasmosis is discussed, along with their significance and importance as auxiliary methods for determining the most likely time for the initial infection by this coccidian and for defining the therapeutic strategy. Lastly, practical comments are made in relation to the classical therapeutic regimens, with special attention to the indications for fetal treatment, when this is necessary.

Etiology and antibiotic susceptibility pattern of community-acquired ...

African Journals Online (AJOL)

Community-acquired urinary tract infections occur in individuals not admitted in hospital prior to development of the symptoms of the infection. It occurs mostly in women and caused by Escherichia coli. The aim of this study was to determine the prevalence of urinary tract infection among individuals residing within Jos ...

Anticuerpos IgG anti-toxoplasma gondii en pacientes con síntomas atribuíbles a toxoplasmosis

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Jorge E. Collazo

1993-12-01

Full Text Available Se evaluaron 6.520 pacientes con síntomas atribuíbles a toxoplasmosis por la presencia de anticuerpos IgG anti - Toxoplasma gondii mediante la técnica de inmunofluorescencia indirecta. El 51,27% de los evaluados resultaron positivos.El 60,85% de los pacientes con trastornos oculares son seropositivos a IgG anti - T. gondii; seguidos del 56,25 y 48,10% para aquellos con trastornos generales y gineco-obstétricos. Los síntomas o manifestaciones que evidenciaron mayor porcentaje de positividad fueron: astenia, coriorretinitis, trastornos menstruales, cefaleas y uveítis.

Predictors of Outcome following Acquired Brain Injury in Children

Science.gov (United States)

Johnson, Abigail R.; DeMatt, Ellen; Salorio, Cynthia F.

2009-01-01

Acquired brain injury (ABI) in children and adolescents can result from multiple causes, including trauma, central nervous system infections, noninfectious disorders (epilepsy, hypoxia/ischemia, genetic/metabolic disorders), tumors, and vascular abnormalities. Prediction of outcomes is important, to target interventions, allocate resources,…

[Cetuximab in combination with icotinib overcomes the acquired resistance caused by EGFR T790M mutation in non-small cell lung cancer].

Science.gov (United States)

Wang, Meng; Zhang, Lianmin; Zhao, Xiaoliang; Liu, Jun; Chen, Yulong; Wang, Changli

2014-09-01

The aim of this study was to investigate the effects of combination of icotinib and cetuximab on the acquired drug resistance caused by T790M mutation of EGFR in NSCLC, and provide experimental evidence for rational treatment of NSCLC. The effects of these two agents on cell proliferation, apoptosis, and EGFR-dependent signaling were evaluated using 3-(4, 5-dimethylthiazol-2-yl)- 5-diphenyltetrazolium bromide (MTT) assay, annexin V staining, and Western blotting. The expression of molecular markers of tumor proliferation PCNA and Ki-67 protein was further examined by immunohistochemistry, and the expression of EGFR-signaling-related proteins in tissue sections taken from H1975 tumor xenografts was assessed by Western blot assay. Sensitivity to EGFR inhibitors was detected in human H1975 tumor xenograft in nude mice. The in vitro experiment showed that the proliferative ability of H1975 cells was inhibited in a dose-dependent manner, along with the increasing doses of cetuximab and icotinib, and the combination of cetuximab with icotinib resulted in a more pronounced growth inhibition of the H1975 cells. The apoptosis rate of H1975 cells after treatment with 0.5 µmol/L icotinib and 1 µg/ml cetuximab was (22.03 ± 2.41)% and that after treatment with 5 µmol/L icotinib and 10 µg/ml cetuximab was (42.75 ± 2.49)%, both were significantly higher than that after treatment with the same dose of icotinib or cetuximab alone (P icotinib treatment, but (30.8 ± 2.0) mm(3) in the cetuximab treatment group and 0 mm(3) in the cetuximab combined with icotinib group. There was a significantly decreased expression of Ki-67 and PCNA proteins and down-regulation of phosphorylation of EGFR signaling-related proteins in the cetuximab combined with icotinib group. The combination of icotinib with cetuximab can exert synergistic inhibitory effect on the acquired drug resistance caused by T790M mutation of EGFR in NSCLC H1975 cells, interrupts the EGFR-downstream signaling pathway

Differences in microbiological profile between community-acquired, healthcare-associated and hospital-acquired infections.

Science.gov (United States)

Cardoso, Teresa; Ribeiro, Orquídea; Aragão, Irene; Costa-Pereira, Altamiro; Sarmento, António

2013-01-01

Microbiological profiles were analysed and compared for intra-abdominal, urinary, respiratory and bloodstream infections according to place of acquisition: community-acquired, with a separate analysis of healthcare-associated, and hospital-acquired. Prospective cohort study performed at a university tertiary care hospital over 1 year. Inclusion criteria were meeting the Centers for Disease Control definition of intra-abdominal, urinary, respiratory and bloodstream infections. A total of 1035 patients were included in the study. More than 25% of intra-abdominal infections were polymicrobial; multi-drug resistant gram-negatives were 38% in community-acquired, 50% in healthcare-associated and 57% in hospital-acquired. E. coli was the most prevalent among urinary infections: 69% in community-acquired, 56% in healthcare-associated and 26% in hospital-acquired; ESBL producers' pathogens were 10% in healthcare-associated and 3% in community-acquired and hospital-acquired. In respiratory infections Streptococcus pneumoniae was the most prevalent in community-acquired (54%) and MRSA in healthcare-associated (24%) and hospital-acquired (24%). A significant association was found between MRSA respiratory infection and hospitalization in the previous year (adjusted OR = 6.3), previous instrumentation (adjusted OR = 4.3) and previous antibiotic therapy (adjusted OR = 5.7); no cases were documented among patients without risk factors. Hospital mortality rate was 10% in community-acquired, 14% in healthcare-associated and 19% in hospital-acquired infection. This study shows that healthcare-associated has a different microbiologic profile than those from community or hospital acquired for the four main focus of infection. Knowledge of this fact is important because the existing guidelines for community-acquired are not entirely applicable for this group of patients.

Toxoplasmosis Infection and Cognitive Deficit after Electroconvulsive Treatment (ECT), Is There a Connection?

Science.gov (United States)

E Berg, John

2012-01-01

Electroconvulsive treatment (ECT) has developed over 70 years to a modern, effective way of lifting depressive moods. Memory loss and visual acuity after electroconvulsive treatment is the only remaining relevant criticism of the treatment modality when considering the overall rate of remission from this treatment compared to all other treatment modalities. A depressive state impedes memory, and memory improves on several qualities of cognition after treatment. However, the comparison of a person's memory ability from the months before depression started to the level after a course of ECT is never performed, for obvious reasons. Some infectious diseases are known to influence memory negatively through effects on the dopamine receptors. More specifically, former toxoplasmosis infection may be a factor. Preliminary data on titres of toxoplasma IgG may indicate a connection to the development of long-standing memory problems after ECT.

Severe Recurrent Achalasia Cardia Responding to Treatment of Severe Autoimmune Acquired Haemophilia

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H. Al-Jafar

2012-09-01

Full Text Available Acquired haemophilia A and severe acquired achalasia are both very rare conditions with unknown aetiology. Haemophilia A is a haemorrhagic disease induced by deficiency or malfunction of coagulation factor VIII. Congenital haemophilia is an inherited disease transmitted by the mother through X-linked inheritance and primarily affects males. However, acquired haemophilia A is a serious, sudden-onset, autoimmune disease that affects either sex. In addition, achalasia is a disease of the oesophagus caused by abnormal function of the nerves and muscles. It causes swallowing difficulties due to the inability of the lower oesophageal sphincter to relax during swallowing, leading to dysphagia, regurgitation and chest pain. In this report, we describe the case of a patient with severe, newly diagnosed, acquired haemophilia A with long-standing, recurrent achalasia; the achalasia had recurred 3 times despite complete and proper surgical fixation. Acquired haemophilia A is treated with immunosuppressive therapy. High-dose steroid therapy was administered for 7 months, during which the patient responded well; moreover, the achalasia did not recur for more than 2 years. The response of the achalasia to immunosuppressive therapy suggests that achalasia may be an autoimmune disorder and that there may be an association between both diseases. The findings of the present case suggest that achalasia may favourably respond to steroid therapy as a first-line treatment prior to surgery.

[Acquired angioedema – clinical characteristic of the patients diagnosed in 2012-2016 with acquired C1 inhibitor deficiency].

Science.gov (United States)

Stobiecki, Marcin; Czarnobilska, Ewa; Obtułowicz, Krystyna

Acquired angioedema is a rare disease caused by a deficiency of C1 esterase inhibitor with recurrent swelling symptoms. It may occur in the course of lymphoproliferative disorders or autoimmune diseases. Symptoms resemble hereditary angioedema, and the only differentiating features is negative family history, late onset of symptoms and accompanying lymphoproliferative disorder. The aim of the study was to analyze the cases of acquired angioedema. The retrospective analysis of 341 patients from the registry of patients with C1 inhibitor deficiency. Results: We identified 4 patients among 119 with HAE (3.57%) diagnosed in this same period of time 2012-2016 who fulfilled the criteria of acquired edema. In two cases the primary reason of angioedema was lymphoproliferive disease, in two monoclonal gammapathy of unknown reason. We analyzed also the results of laboratory tests C4, C1 inhibitor, C1q. In all cases the face was dominated localization. After the treatment of primary lymphoproliferive disease, in two cases, we observed total remission of angioedema. Only one patient with gammapathy require treatment with C1 inhibitor during the attacks. In these case we observed both plasma deriver, and recombinant C1 inhibitor were effective.

Evaluation of an educational handout on knowledge about toxoplasmosis = Avaliação de um folheto educativo abordando o conhecimento sobre toxoplasmose

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Dabritz, Haydee A.

2010-01-01

Conclusions: Knowledge about toxoplasmosis increased in all areas evaluated, but gaps remained, particularly with regard to environmental sources of Toxoplasma gondii infection and clinical manifestations of disease. In addition to care in handling cat faeces/litter and avoidance of undercooked meat, healthcare providers counseling pregnant women should emphasize the importance of wearing gloves when gardening, hand washing after handling soil or meat, and rinsing fresh vegetables thoroughly before consumption

AN EVALUATION STUDY OF ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) USING RECOMBINANT PROTEIN GRA1 FOR DETECTION OF IgG ANTIBODIES AGAINTS TOXOPLASMA GONDII INFECTIONS

OpenAIRE

Muflikhah, Nina Difla; Artama, Wayan Tunas

2017-01-01

Toxoplasmosis is an infectious disease caused by Toxoplasma gondii, an intracellular protozoan parasite that live inside the cells of the reticulo endothelial and parenchymal cells of human and animals (mammals and birds). Some cases of toxoplasmosis usually have no symptoms, but in any cases caused severe symptoms, such as hydrocephalus, microcephalus, intracranial calcification, retinal damage, brain abscess, mental retardation, lymphadenopathy, and others. Its severe symptoms usually showe...

Ocular Toxoplasmosis: Lessons from Brazil

Science.gov (United States)

• A new attention to post-natally acquired infections. Previously, most attention was focused on infection during pregnancy, and the risk of congenital disease, with the feeling that infection in older individuals was benign, without a substantial risk of disease morbidity, such as ocular involvemen...

Experimental toxoplasmosis in Balb/c mice. Prevention of vertical disease transmission by treatment and reproductive failure in chronic infection

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B Fux

2000-01-01

Full Text Available In a study of congenital transmission during acute infection of Toxoplasma gondii, 23 pregnant Balb/c mice were inoculated orally with two cysts each of the P strain. Eight mice were inoculated 6-11 days after becoming pregnant (Group 1. Eight mice inoculated on the 10th-15th day of pregnancy (Group 2 were treated with 100 mg/kg/day of minocycline 48 h after inoculation. Seven mice inoculated on the 10th-15th day of pregnancy were not treated and served as a control (Group 3. Congenital transmission was evaluated through direct examination of the brains of the pups or by bioassay and serologic tests. Congenital transmission was observed in 20 (60.6% of the 33 pups of Group 1, in one (3.6% of the 28 pups of Group 2, and in 13 (54.2% of the 24 pups of Group 3. Forty-nine Balb/c mice were examined in the study of congenital transmission of T. gondii during chronic infection. The females showed reproductive problems during this phase of infection. It was observed accentuated hypertrophy of the endometrium and myometrium. Only two of the females gave birth. Our results demonstrate that Balb/c mice with acute toxoplasmosis can be used as a model for studies of congenital T. gondii infection. Our observations indicate the potential of this model for testing new chemotherapeutic agents against congenital toxoplasmosis.

Behçet's syndrome / AIDS / cerebral toxoplasmosis: an unusual association

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Wiliam Habib Chahade

Full Text Available Few cases of AIDS associated to manifestations suggesting Behçet's syndrome have been reported. This case is of a young married woman who presented, during a period of 7 years, clinical manifestations consistent with the late diagnosis of Behçet's syndrome, when she developed recurrent lymphomonocytic meningoencephalitis. At this time, she was found to be infected by HIV-1. Immunosupressive doses of glucocorticoid produced an unsatisfactory response and she evolved to death due to CNS toxoplasmosis. The latter diagnosis was presumed on the basis of magnetic resonance imaging findings and proved by necropsy after her third hospital stay. One of the factors hindering the appropriate diagnosis was the low level of CD4 and the CD4/CD8 ratio, sometimes observed in active Behçet's syndrome and higher than those observed in patients with this severe opportunistic infection. No information about the exact period of time she had been infected with HIV-1 is available. So, we do not know whether both diseases were overlor, if the patient, infected by HIV-1, developed an unusual clinical feature consistent with Behçet's Behçet's syndrome, and subsequently evolved to AIDS.

Prevalence of Mycoplasma pneumoniae : A cause for community ...

African Journals Online (AJOL)

Prevalence of Mycoplasma pneumoniae : A cause for community‑acquired ... Atypical pneumonia caused by Mycoplasma pneumoniae is a leading cause of ... microscopic and biochemical studies for better diagnosis of these pathogens.

Health Data Publications No. 30. Burma (Union of Burma)

Science.gov (United States)

1966-01-01

Toxoplasmosis 40 Mycotic Infections 40 Helminthiasis 40 Filaria sis 41 Dracontiasis 41 Bilharziasis (Schistosomiasis) 42 Fascioliasis 42 Paragonimiasis 42...schistosomiasis is acquired in Burma. Fascioliasis Infection with the trematode Fasciola hepatica has been found in Burma and is of importance in at least

Does excessive pronation cause pain?

DEFF Research Database (Denmark)

Olesen, C G; Nielsen, Rasmus Gottschalk N; Rathleff, Michael Skovdal

2008-01-01

Excessive pronation could be an inborn abnormality or an acquired foot disorder caused by overuse, inadequate supported shoes or inadequate foot training. When the muscles and ligaments of the foot are insufficient it can cause an excessive pronation of the foot. The current treatment consist of ...

Acquired portosystemic collaterals: anatomy and imaging

Energy Technology Data Exchange (ETDEWEB)

Leite, Andrea Farias de Melo; Mota Junior, Americo, E-mail: andreafariasm@gmail.com [Instituto de Medicina Integral Professor Fernando Figueira de Pernambuco (IMIP), Recife, PE (Brazil); Chagas-Neto, Francisco Abaete [Universidade de Fortaleza (UNIFOR), Fortaleza, CE (Brazil); Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco [Universidade de Sao Paulo (FMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina

2016-07-15

Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common - increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. (author)

Acquired portosystemic collaterals: anatomy and imaging

International Nuclear Information System (INIS)

Leite, Andrea Farias de Melo; Mota Junior, Americo; Chagas-Neto, Francisco Abaete; Teixeira, Sara Reis; Elias Junior, Jorge; Muglia, Valdair Francisco

2016-01-01

Portosystemic shunts are enlarged vessels that form collateral pathological pathways between the splanchnic circulation and the systemic circulation. Although their causes are multifactorial, portosystemic shunts all have one mechanism in common - increased portal venous pressure, which diverts the blood flow from the gastrointestinal tract to the systemic circulation. Congenital and acquired collateral pathways have both been described in the literature. The aim of this pictorial essay was to discuss the distinct anatomic and imaging features of portosystemic shunts, as well as to provide a robust method of differentiating between acquired portosystemic shunts and similar pathologies, through the use of illustrations and schematic drawings. Imaging of portosystemic shunts provides subclinical markers of increased portal venous pressure. Therefore, radiologists play a crucial role in the identification of portosystemic shunts. Early detection of portosystemic shunts can allow ample time to perform endovascular shunt operations, which can relieve portal hypertension and prevent acute or chronic complications in at-risk patient populations. (author)

Toxoplasmosis in sentinel chickens (Gallus domesticus) in New England farms: seroconversion, distribution of tissue cysts in brain, heart, and skeletal muscle by bioassay in mice and cats

Science.gov (United States)

Free-range chickens are a good indicator of soil contamination with oocysts because they feed from the ground and they are also an important source of infection for cats that in turn shed oocysts after eating tissues of intermediate hosts. Little is known of the epidemiology of toxoplasmosis in chic...

Hospital-Acquired Pneumonia in Newborns with Birth Weight Less Than 1500 Grams: Risk Factors and Causes

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Folic Nevena

2016-12-01

Full Text Available Low birth weight newborns (≤1500 grams are at a high risk of acquiring hospital infections due to the immaturity of the immune system, lack of efficient structural barriers, and an incomplete development of endogenous microbial flora.

Evaluation of a Commercial IgE ELISA in Comparison with IgA and IgM ELISAs, IgG Avidity Assay and Complement Fixation for the Diagnosis of Acute Toxoplasmosis

Czech Academy of Sciences Publication Activity Database

Kodym, P.; Machala, L.; Roháčová, H.; Širocká, B.; Malý, Marek

2007-01-01

Roč. 13, č. 1 (2007), s. 40-47 ISSN 1198-743X Source of funding: V - iné verejné zdroje Keywords : acute infection * diagnosis * IgE ELISA * lymphadenopathy * serology * toxoplasmosis Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 2.980, year: 2007

High rate of mutation K103N causing resistance to nevirapine in Indian children with acquired immunodeficiency syndrome

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Sehgal S

2008-01-01

Full Text Available In north India the number of paediatric cases with acquired immunodeficiency syndrome (AIDS is on the rise. Most drug combinations used for treatment of AIDS incorporate nevirapine, resistance to which develops very fast if given singly or because of unplanned interruptions. This paper investigates presence of mutations at codon 103 and codon 215 of the HIV pol gene causing resistance to nevirapine and zidovudine (AZT respectively in 25 children with AIDS. Mutations T215Y and K103N were detected by a nested cum amplification refractory mutation system polymerase chain reaction (ARMS PCR and the results were confirmed by direct sequencing in five randomly selected cases. Nineteen patients had received nevirapine containing regimen and six were drug naive. Mutation K103N was observed in 56% (14/25 of the children while mutation T215Y was found in none. Two of the six drug naοve children also showed K103N mutation. Thus, Indian children drug naοve or treated with nevirapine containing regimens show a high rate of mutation conferring resistance to nevirapine which calls for a judicious use of nevirapine both in antenatal and postnatal setting.

[Ceftaroline fosamil in community-acquired and nosocomial pneumonia].

Science.gov (United States)

Calbo, Esther; Zaragoza, Rafael

2014-03-01

Community-acquired pneumonia (CAP) is a common infection in developed countries and causes a large number of hospital admissions and deaths. In recent years, the incidence of this disease has increased, caused by progressive population aging. Following the introduction of the conjugate vaccine against Streptococcus pneumoniae, there have been significant epidemiological changes that require close monitoring because of the possible emergence of new patterns of resistance. This article aims to review the role of ceftaroline fosamil, a new parenteral cephalosporin with antibacterial activity against Gram-negative and Gram-positive pathogens, in the treatment of pneumonia. Several in vitro and in vivo studies have shown the efficacy of ceftaroline fosamil against penicillin-resistant S. pneumoniae and methicillin-resistant Staphylococcus aureus (MRSA). Additionally, ceftaroline has shown similar efficacy and safety to ceftriaxone in the treatment of community-acquired pneumonia with severe prognosis (prognostic severity index III and IV) in two phase III clinical trials. Although a non-inferiority design was used for these clinical trials, some data suggest a superior efficacy of ceftaroline, with earlier clinical response and higher cure rate in infections caused by S. pneumoniae, making this drug particularly interesting for critically-ill patients admitted to the intensive care unit. Ceftaroline may also be considered for empirical and directed treatment of MRSA pneumonia. Copyright © 2014 Elsevier España, S.L. All rights reserved.

Elderly patients with community-acquired pneumonia are not treated according to current guidelines

DEFF Research Database (Denmark)

Lindhardt Damsgaard, Tove; Klausen, Henrik Hedegaard; Christiansen, Christina

2013-01-01

Community-acquired pneumonia (CAP) is a major cause of morbidity and mortality in elderly patients, and the most important cause of death in the developed world. Optimised treatment and care will benefit patients as well as the health economy. This study investigated in-hospital compliance...

Fatal disseminated toxoplasmosis in an immunocompetent cat

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Susanna S. Nagel

2013-02-01

Full Text Available A 10-year-old domestic short hair cat was referred for investigation of anorexia and polydipsia of 3 days’ duration. Clinically the cat was obese, pyrexic (39.8 °C, had acute abdominal pain and severe bilirubinuria. Haematology and serum biochemistry revealed severe panleukopenia, thrombocytopenia, markedly elevated alanine aminotransferase (ALT and five-fold increased pre-prandial bile acids. Ultrasonographic evaluation of the abdomen did not identify any abnormalities. Serum tests for feline immunodeficiency virus (FIV and feline leukaemia virus (FeLV were negative. Broad-spectrum antibiotic treatment for infectious hepatitis was to no avail; the cat deteriorated and died 72 h after admission. Necropsy revealed mild icterus and anaemia, severe multifocal hepatic necrosis, serofibrinous hydrothorax, pulmonary oedema and interstitial pneumonia. Histopathology confirmed the macroscopic findings and revealed multifocal microgranulomata in the brain and myocardium, as well as areas of necrosis in lymph nodes and multifocally in splenic red pulp. Long bone shaft marrow was hyperplastic with a predominance of leukocyte precursors and megakaryocytes and splenic red pulp showed mild extramedullary haemopoiesis. Immunohistochemical staining for Toxoplasma gondii was strongly positive, with scattered cysts and tachyzoites in the liver, lymph nodes, spleen, lungs, brain, salivary glands and intracellularly in round cells in occasional blood vessels. Immunohistochemical staining for corona virus on the same tissues was negative, ruling out feline infectious peritonitis (FIP. Polymerase chain reaction (PCR on formalin-fixed paraffin-wax embedded tissues was positive for Toxoplasma sp., but attempts at sequencing were unsuccessful. This was the first case report of fulminant disseminated toxoplasmosis in South Africa, in which detailed histopathology in an apparently immunocompetent cat was described.

Fatal disseminated toxoplasmosis in an immunocompetent cat.

Science.gov (United States)

Nagel, Susanna S; Williams, June H; Schoeman, Johannes P

2013-02-14

A 10-year-old domestic short hair cat was referred for investigation of anorexia and polydipsia of 3 days' duration. Clinically the cat was obese, pyrexic (39.8 °C), had acute abdominal pain and severe bilirubinuria. Haematology and serum biochemistry revealed severe panleukopenia, thrombocytopenia, markedly elevated alanine aminotransferase (ALT) and five-fold increased pre-prandial bile acids. Ultrasonographic evaluation of the abdomen did not identify any abnormalities. Serum tests for feline immunodeficiency virus (FIV) and feline leukaemia virus (FeLV) were negative. Broad-spectrum antibiotic treatment for infectious hepatitis was to no avail; the cat deteriorated and died 72 h after admission. Necropsy revealed mild icterus and anaemia, severe multifocal hepatic necrosis, serofibrinous hydrothorax, pulmonary oedema and interstitial pneumonia. Histopathology confirmed the macroscopic findings and revealed multifocal microgranulomata in the brain and myocardium, as well as areas of necrosis in lymph nodes and multifocally in splenic red pulp. Long bone shaft marrow was hyperplastic with a predominance of leukocyte precursors and megakaryocytes and splenic red pulp showed mild extramedullary haemopoiesis. Immunohistochemical staining for Toxoplasma gondii was strongly positive, with scattered cysts and tachyzoites in the liver, lymph nodes, spleen, lungs, brain, salivary glands and intracellularly in round cells in occasional blood vessels. Immunohistochemical staining for corona virus on the same tissues was negative, ruling out feline infectious peritonitis (FIP). Polymerase chain reaction (PCR) on formalin-fixed paraffin-wax embedded tissues was positive for Toxoplasma sp., but attempts at sequencing were unsuccessful. This was the first case report of fulminant disseminated toxoplasmosis in South Africa, in which detailed histopathology in an apparently immunocompetent cat was described.

Idiopathic Acquired Hemophilia A with Undetectable Factor VIII Inhibitor

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Nicholas B. Abt

2014-01-01

Full Text Available Objective. We present the case of a 73-year-old female, with no family or personal history of a bleeding disorder, who had a classic presentation for acquired hemophilia A. Factor VIII activity was low but detectable and a factor VIII inhibitor was undetectable. Methods. The patient’s plasma was comprehensively studied to determine the cause of the acquired coagulopathy. Using the Nijmegen modification of the Bethesda assay, no factor VIII autoantibody was measureable despite varying the incubation time from 1 to 3 hours. Results. The aPTT was prolonged at 46.8 seconds, which did not correct in the 4 : 1 mix but did with 1 : 1 mix. Using a one stage factor VIII activity assay, the FVIII activity was 16% and chromogenic FVIII activity was also 16%. The patient was treated with recombinant FVII and transfusion, significantly reducing bleeding. Long-term therapy was initiated with cyclophosphamide and prednisone with normalization of FVIII activity. Conclusions. Physicians can be presented with the challenging clinical picture of an acquired factor VIII inhibitor without a detectable inhibitor by the Bethesda assay. Standard therapy for an acquired hemophilia A should be considered.

Establishing Genotype-to-Phenotype Relationships in Bacteria Causing Hospital-Acquired Pneumonia: A Prelude to the Application of Clinical Metagenomics

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Etienne Ruppé

2017-11-01

Full Text Available Clinical metagenomics (CMg, referred to as the application of next-generation sequencing (NGS to clinical samples, is a promising tool for the diagnosis of hospital-acquired pneumonia (HAP. Indeed, CMg allows identifying pathogens and antibiotic resistance genes (ARGs, thereby providing the information required for the optimization of the antibiotic regimen. Hence, provided that CMg would be faster than conventional culture, the probabilistic regimen used in HAP could be tailored faster, which should lead to an expected decrease of mortality and morbidity. While the inference of the antibiotic susceptibility testing from metagenomic or even genomic data is challenging, a limited number of antibiotics are used in the probabilistic regimen of HAP (namely beta-lactams, aminoglycosides, fluoroquinolones, glycopeptides and oxazolidinones. Accordingly, based on the perspective of applying CMg to the early diagnostic of HAP, we aimed at reviewing the performances of whole genomic sequencing (WGS of the main HAP-causing bacteria (Enterobacteriaceae, Pseudomonas aeruginosa, Acinetobacter baumannii, Stenotrophomonas maltophilia and Staphylococcus aureus for the prediction of susceptibility to the antibiotic families advocated in the probabilistic regimen of HAP.

Pediatric acquired brain injury.

Science.gov (United States)

Bodack, Marie I

2010-10-01

Although pediatric patients are sometimes included in studies about visual problems in patients with acquired brain injury (ABI), few studies deal solely with children. Unlike studies dealing with adult patients, in which mechanisms of brain injury are divided into cerebral vascular accident (CVA) and traumatic brain injury (TBI), studies on pediatric patients deal almost exclusively with traumatic brain injury, specifically caused by accidents. Here we report on the vision problems of 4 pediatric patients, ages 3 to 18 years, who were examined in the ophthalmology/optometry clinic at a children's hospital. All patients had an internally caused brain injury and after the initial insult manifested problems in at least one of the following areas: acuity, binocularity, motility (tracking or saccades), accommodation, visual fields, and visual perceptual skills. Pediatric patients can suffer from a variety of oculo-visual problems after the onset of head injury. These patients may or may not be symptomatic and can benefit from optometric intervention. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

Toxoplasmic meningoencephalitis

International Nuclear Information System (INIS)

Yamashita, Seizo; Sales, Magaly Machado

1998-01-01

Toxoplasmosis is one of the most common infections in the acquired immunodeficiency syndrome, occurring in about 19% of the patients. This article is a short communication about pathologic findings and imaging findings by computed tomography and magnetic resonance imaging in the toxoplasmic meningoencephalitis. (author)

Treatment of Congenital Toxoplasmosis: Safety of the Sulfadoxine-Pyrimethamine Combination in Children Based on a Method of Causality Assessment.

Science.gov (United States)

Teil, Julie; Dupont, Damien; Charpiat, Bruno; Corvaisier, Stéphane; Vial, Thierry; Leboucher, Gilles; Wallon, Martine; Peyron, François

2016-06-01

The treatment of newborns and infants with congenital toxoplasmosis is standard practice. Some observational studies have examined safety in newborns, but most of these failed to provide sufficient details for a provisional assessment of causality. The aim of this study was to evaluate the clinical and biological adverse effects of the combination of sulfadoxine-pyrimethamine. Sixty-five children treated for 1 year with a combination of sulfadoxine-pyrimethamine (1 dose every 10 days) for congenital toxoplasmosis were followed up to evaluate abnormal hematological values and potential adverse events using a standardized method of causality assessment. Nine patients (13.8%) presented at least 1 adverse clinical event that was nonspecific, such as diarrhea on the day of drug administration, vomiting and agitation. In 1 patient, erythema appeared at the end of the treatment and resolved within 10 days. None of these events was attributed to the treatment. Six patients (9.2%) developed an adverse hematological event (neutropenia, n = 3; eosinophilia, n = 2 and both anemia and eosinophilia, n = 1) that was considered to be possibly related to the sulfadoxine-pyrimethamine combination. Four treatments were temporarily interrupted, and toxicity was observed after readministration of treatment in 1 case only. However, none of these adverse events was life threatening. According to our results and previously published data, the combination of sulfadoxine-pyrimethamine seems to be well tolerated. However, the sample size of our study was too small to rule out the risk of less frequent, but nevertheless severe, reactions and, in particular, of hypersensitivity reactions.

Advanced Methods for Clinical Outcome Prediction in Acquired Heart Disease

NARCIS (Netherlands)

L.C. Battes (Linda)

2014-01-01

markdownabstract__Abstract__ Acquired heart disease, which includes conditions such as coronary artery disease (CAD) and heart failure, continues to pose a large impediment on the individuals that suffer from it as well as on society in general. CAD is the leading cause of death in the

Seroepidemiological study of toxoplasmosis in southern districts of Tamil Nadu.

Science.gov (United States)

Sucilathangam, G; Anna, T

2016-06-01

The current study was conducted with the objectives of estimating the seroprevalence of Toxoplasma gondii and associated socio-demographic, clinical and behavioural characteristics in and around Tirunelveli. Serum samples from 175 immunodeficient and 175 immunocompetent patients were collected and were analyzed by in-house enzyme linked immunosorbent assay (ELISA). A questionnaire survey was administered for all study participants to gather information on risk factors. The present study revealed that anti- T. gondii IgG antibodies were detected in 13.14 % which constitutes 15.43 % in immunocompromised and 10.86 % in immunocompetent patients. There was a significant difference between sex of the study population and drinking water source. Seroprevalence was increased in the male (19.12 %, p = 0.0075, OR 2.316, 95 % CI 1.2362-4.3405) than the female and with river water consumption other than bore water (12.5 %, p = 0.0483, OR 0.857, 95 % CI 0.1853-3.4641). No significant relations were observed between anti-Toxoplasma IgG antibodies and age, residence, diet and animal contact in the study population. Toxoplasmosis will remain a problem, mainly in risk groups such as pregnant women and immunocompromised patients. Improvement can only be attained by increasing prevention and reducing the risk factors.

Acquired Inhibitors: A Special Case of Bleeding in Older Adults

Directory of Open Access Journals (Sweden)

Richard G. Stefanacci

2012-01-01

Full Text Available This literature review is intended to familiarize physicians and healthcare providers of older adults with the potential causes of acute bleeding in older adults and to review diagnostic approaches that can produce prompt identification of acute bleeding and facilitate timely treatment. Adverse events from anticoagulant treatment and nonsteroidal anti-inflammatory drug (NSAID and aspirin use and abuse are among the most common causes of bleeding in older adults. Diagnoses infrequently considered—mild congenital hemophilia, acquired hemophilia, von Willebrand disease, and platelet dysfunction—can contribute to acute bleeding in older adults. The approach to management of bleeding varies. Management of acute bleeding in older adults can be challenging because these patients often have chronic comorbidity and have been prescribed long-term concomitant medications that can complicate diagnosis and treatment. Prompt recognition of acquired hemophilia, referral to an expert hematologist, and timely initiation of treatment could improve outcome in older patients who experience bleeding episodes resulting from this condition.

Towards Universal Screening for Toxoplasmosis: Rapid, Cost-effective and Simultaneous Detection of Toxoplasma Anti-IgG, IgM and IgA Antibodies Using Very Small Serum Volumes

Science.gov (United States)

No dataset associated with this publication.This dataset is associated with the following publication:Augustine, S. Towards Universal Screening for Toxoplasmosis: Rapid, Cost-effective and Simultaneous Detection of Toxoplasma Anti-IgG, IgM and IgA Antibodies Using Very Small Serum Volumes. JOURNAL OF CLINICAL MICROBIOLOGY. American Society for Microbiology, Washington, DC, USA, 56(7): 1-2, (2016).

A case of an immunocompetent young man obtaining community-acquired disseminated Nocardia brasiliensis.

Science.gov (United States)

Li, Jinna; Cao, Jie; Wu, Yueqing; Wan, Nansheng; Pan, Li; Chen, Yuanbao

2014-01-01

Nocardiosis is a rare but severe pyogenic or granulomatous disease and caused by Nocardia that mainly infects immunocompromised patients. We report here a case of an immunocompetent 24-year-old male student with community-acquired pneumonia with asymptomatic disseminated cerebral abscess by Brasiliensis nocardiosis. The patient was fully recovered after receiving optimized antimicrobial therapy without relapse. This case suggests the health professionals such as the physicians of pulmonary, infection, neurology department and et al should always think about unusual cause of community acquired pneumonia, even in immunocompetent patients and when having pulmonary nocardiosis we should do a radiological neurological work up, even with the absence of neurological finding or symptom. Copyright © 2014 Elsevier Inc. All rights reserved.

Animal-friendly production systems may cause re-emergence of Toxoplasma gondii

NARCIS (Netherlands)

Kijlstra, A.; Meerburg, B.G.; Mul, M.F.

2004-01-01

Toxoplasmosis is still one of the most common parasitic infections in the world, although in Europe improvements in hygiene and the introduction of `total` indoor farming in livestock production have rapidly diminished the problem during the past decades. As a result of public dislike, however,

Association of Parasite Load Levels in Amniotic Fluid With Clinical Outcome in Congenital Toxoplasmosis.

Science.gov (United States)

Yamamoto, Lidia; Targa, Lília S; Sumita, Laura M; Shimokawa, Paulo T; Rodrigues, Jonatas C; Kanunfre, Kelly A; Okay, Thelma S

2017-08-01

To correlate neonatal and infant clinical outcome with parasite load in amniotic fluid (AF). We conducted a retrospective cohort study of 122 children whose mothers had toxoplasmosis during pregnancy. The children were monitored from birth to 12 months old. Stored AF samples were obtained at maternal diagnosis and tested by quantitative polymerase chain reaction. Gestational age at maternal infection, quantitative polymerase chain reaction results, neonatal anti-Toxoplasma gondii immunoglobulin (Ig) M, and clinical outcome at 12 months were correlated. Maternal infection occurred in 18 of 122 (14.7%) and 104 of 122 (85.2%) women in the first and second trimesters, respectively. At birth, IgM was present in 107 of 122 (87.7%) neonates and 36 (29.5%) were symptomatic. Of these, half occurred in the first and the other half in the second trimester and 6 of 36 had severe infections (16.7% of symptomatic, 4.9% of total), all infected in the first trimester. Parasite load levels were highly variable (median 35 parasites/mL, range 2-30,473). Logistic regression correlated symptomatic infection with gestational age (odds ratio [OR] 0.47, CI 0.31-0.73) and parasite load (OR 2.04, CI 1.23-3.37), but not with positive IgM (OR 6.81, CI 0.86-53.9). Negative correlations were found between gestational age and parasite load (rs -0.780, CI -0.843 to -0.696), gestational age and symptoms (rs -0.664, CI -0.755 to -0.547), but not gestational age and IgM (rs -0.136, CI -0.311 to 0.048). Parasite load levels distributed by percentile showed that all symptomatic patients appeared from the 75th percentile and all severe infections from the 95th percentile. Load rankings showed doubled the OR for each 20 parasite/mL increment. Parasite load was associated with symptomatic infections (area under the curve 0.959, CI 0.908-0.987) as well as gestational age (area under the curve 0.918, CI 0.855-0.960) and both parameters combined (area under the curve 0.969, CI 0.920-0.992). Parasite load in

Toxoplasmosis in Caribbean islands: Seroprevalence in pregnant women in ten countries, and isolation and report of new genetic types of Toxoplasma gondii from dogs from St. Kitts, West Indies

Science.gov (United States)

Little is known of clinical toxoplasmosis in humans and animals in the Caribbean countries. We investigated the prevalence of IgG and IgMantibodies in 437 pregnant women from 10 English speaking Caribbean countries. Antibodies (IgG) to T. gondii (modified agglutination test, MAT, cut-off 1:6) were f...

Learning-by-Being-Acquired

DEFF Research Database (Denmark)

Colombo, Massimo Gaetano; Moreira, Solon; Rabbiosi, Larissa

2016-01-01

In horizontal acquisitions, the post-acquisition integration of the R&D function often damages the inventive labor force and results in lower innovative productivity of acquired inventors. In this paper we study post-acquisition integration in terms of R&D team reorganization-i.e., the creation...... of new teams with both inventors of the acquiring and acquired firms-and assess the impact of this integration action in the period that immediately follows the acquisition. Drawing on social identity and self-categorization theories, we argue that R&D team reorganization increases the acquired inventors...

Causes of permanent childhood hearing impairment

NARCIS (Netherlands)

Korver, Anna M. H.; Admiraal, Ronald J. C.; Kant, Sarina G.; Dekker, Friedo W.; Wever, Capi C.; Kunst, Henricus P. M.; Frijns, Johan H. M.; Oudesluys-Murphy, Anne Marie; Oudesluys-Murphy, A. M.; Korver, A. M. H.; Frijns, J. H. M.; Wever, C. C.; Konings, S.; Beers, W.; Dekker, F. W.; de Vries, J. J. C.; Vossen, A. C. T. M.; Kant, S. G.; van den Akker-van Marle, M. E.; Rieffe, C.; Ens-Dokkum, M. H.; van Straaten, H. L. M.; Uilenburg, N. N.; Elvers, B.; Loeber, G.; Meuwese-Jongejeugd, J.; Maré, M. J.; Van Zanten, G. A.; Goedegebure, A.; Coster, F.; Goverts, S. T.; Admiraal, R. J. C.; Cremers, C. W. R. J.; Kunst, H. P. M.; de Leeuw, M.; Dijkhuizen, J.; Scharloo, M.; Hoeben, D.; Rijpma, G.; Graef, W.; Linschoten, D.; Kuijper, J.; Hof, N. J.; Pans, D.; Jorritsma, F.; van Beurden, M.; ter Huurne, C. T.; Brienesse, P.; Koldewijn, G. J.; Letourneur, K. G.

2011-01-01

The causes of Permanent Childhood Hearing Impairment (PCHI) are often quoted as being hereditary in 50%, acquired in 25%, and unknown in 25% of cases. Interest in the causes of PCHI has grown recently due to increasing diagnostic possibilities. We investigated the evidence for the reported

Causes of permanent childhood hearing impairment

NARCIS (Netherlands)

Korver, A.M.; Admiraal, R.J.C.; Kant, S.G.; Dekker, F.W.; Wever, C.; Kunst, H.P.M.; Frijns, J.H.; Oudesluys-Murphy, A.M.

2011-01-01

INTRODUCTION: The causes of Permanent Childhood Hearing Impairment (PCHI) are often quoted as being hereditary in 50%, acquired in 25%, and unknown in 25% of cases. Interest in the causes of PCHI has grown recently due to increasing diagnostic possibilities. We investigated the evidence for the