Toxoplasmosis

Notes
  • Toxoplasmosis is a disease caused by Toxoplasma gondii, an obligate intracellular parasitic protozoa.
  • It infects practically all mammalian and avian species but domestic cats (and other family Felidae) are the definitive hosts for gondii.
  • Statistics: Proportion of global population that is thought to be infected - 25%. Average seroprevalence in Africa- 37%; seroprevalence in Kenya - 42% (54% among HIV positive individuals). Toxoplasmosis reactivation in AIDS patients (if no treatment is provided) - 30 to 40%
  1. Transmission
  • Life-cycle;

_Oocysts in cat’s feces

_Materials contaminated with cat’s feces are ingested by intermediate hosts such as domentic animals and rodents

_Oocysts develop into tachyzoites

_Tachyzoites spread throughout the body and form tissue cysts in neural and muscle tissue

_Humans are infected by ingesting undercooked meat containing tissue cysts, materials contaminated with cat’s feces, by blood transfusion and transplacental transmission from mother to fetus occurs.

_Formation of tissue cysts in human  mainly in skeletal muscle, myocardium, the brain, and the eyes

_Reactivation of the cysts (though rare) in the immunocompromised host

Symptoms
  • Mainly asymptomatic
  • Benign lymphadenopathy
  • Encephalitis (especially in the immuno-compromise individuals)
  • Ring-enhancing intracranial mass lesions
  • Seizures
  • Flu-like syndrome
  • Retinochoroiditis
  • Intellectual disability occur
Diagnosis
  • Serologic Tests (IgG & IgM detection)
  • Histology
  • PCR
  • MRI or CT of the skull
Management
  • Rx;

_Tabs Pyrimethamine 200mg in 2 doses on day 1, then 25-100mg for 6-8 wks.

_Tabs Sulphadiazine 75mg /kg (max.4gm) day 1, then  100mg/kg/day (max. 6gm) in 2 divided doses for 6-8 wks.

_Caps Clindamycin 600-1200mg TID with any of the two drugs above for 6-8 wks.

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