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WHAT IS TOXOPLASMOSIS • Toxoplasmosis is in infection that is caused by a microscopic parasite called Toxoplasma gondi. • T. gondii is a coccidian protozoan that multiplies only in living cells • Tissue cysts, may contain thousands of parasites and remain in tissues, especially the CNS and skeletal and heart muscle, for the life of the host. • These microscopic parasites live inside the cells of humans and animals (cats and farm animals).
In immunologically normal children, acute acquired infection may be asymptomatic, cause lymphadenopathy, or affect almost any organ. • latent encysted organisms persist in the host throughout life • In immunocompromised infants or children, either initial acquisition or recrudescence of latent organisms often causes signs or symptoms related to the central nervous system (CNS) • Congenital infection, if untreated, often causes disease either perinatally or later in life
Toxoplasma infection is ubiquitous in animals and is 1 of the most common latent infections of humans throughout the world • In many areas of the world, approximately 3–35% of pork, 7–60% of lamb, and 0–9% of beef contain T. gondii organisms. • Significant antibody titers are detected in 50–80% of residents of some localities such as France, Brazil, and Central America, and in <5% in other areas
HOW DO PEOPLE GET TOXOPLASMOSIS? • By touching or coming into contact with infected cat feces. • By eating contaminated raw or undercooked meat. • By eating contaminated unwashed fruits or vegetables. • By passing it to your unborn baby. • By organ transplant or blood transfusion
Acquired Toxoplasmosis • Immunocompetent children who acquire infection postnatally generally have do not have clinically recognizable symptoms • Symptomatic infection is characterized as a heterophil-negative mononucleosis syndrome that includes: lymphadenopathy, fever, and hepatosplenomegaly. • Disseminated infection, including myocarditis, pneumonia, and CNS toxoplasmosis, is more common among immunocompromised persons,
fever, stiff neck, myalgia, arthralgia, maculopapular rash that spares the palms and soles, localized or generalized lymphadenopathy, hepatomegaly, hepatitis, reactive lymphocytosis, meningitis, brain abscess, encephalitis, confusion, malaise, pneumonia, polymyositis, pericarditis, pericardial effusion, and myocarditis.
Acquired Toxoplasmosis • Chorioretinitis, usually unilateral, occurs in approximately 1% . • The most common manifestation is enlargement of 1 or a few cervical lymph nodes.
WHAT IS CONGENTIAL TOXOPLASMOSIS • When a pregnant woman gets the infection during pregnancy and passes it on to her fetus. • Women who get toxoplasmosis before conception hardly ever pass the infection during pregnancy. • Babies that get infected during the first trimester show to have the most severe symptoms.
CONGENTIAL TOXOPLASMOSIS • Congenital infection may present as a mild or severe neonatal disease
(congenital infection) • Mild signs: premature birth, small size for gestational age, retinal scars, persistent jaundice, mild thrombocytopenia, CSF pleocytosis • More severe signs: • Psychomotor retardation and resulting low IQ • Seizures / Blindness, sometimes deafness • Severe disease and death
CONGENTIAL TOXOPLASMOSIS • characteristic triad of chorioretinitis, hydrocephalus, and cerebral calcifications. More than half of congenitally infected infants
DIAGNOSIS. • Culture. • Serologic Testing • PCR
TREATMENT • Acquired Toxoplasmosis and lymphadenopathy do not need specific treatment unless they have severe and persistent symptoms or evidence of damage to vital organs. • If such signs and symptoms occur, treatment with pyrimethamine, sulfadiazine, and leukovorin should be initiated
TREATMENT • Congenital Toxoplasmosis :All newborns infected with T. gondii should be treated whether or not they have clinical manifestations of the infection because treatment may be effective in interrupting acute disease that damages vital organs. • Infants should be treated for 1 yr with pyrimethamine .sulfadiazine and leukovorin