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Toxoplasmosis
Kinds of Toxoplasmosis Selected AbstractsFine-needle aspiration cytology of subcutaneous toxoplasmosis: A case reportDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2010Xiaowei Chen M.D. Abstract Toxoplasmosis is a common opportunistic infection in patients with AIDS in whom it typically presents as encephalitis, pneumonia, lymphadenitis, and myocarditis. Skin involvement is very rare and, to our best knowledge, Toxoplasma gondii forming a subcutaneous mass has not been reported. Here, we report the findings of an interesting case of subcutaneous toxoplasmosis with the cytological appearance of an inflammatory fibrovascular lesion in a HIV-positive patient and discuss the differential diagnosis. Diagn. Cytopathol. 2010;38:716,720. © 2009 Wiley-Liss, Inc. [source] Frequent Hemorrhagic Lesions in Cerebral Toxoplasmosis in AIDS PatientsJOURNAL OF NEUROIMAGING, Issue 2 2009Satyakam Bhagavati MD ABSTRACT Cerebral toxoplasmosis is a frequent complication in immunosuppressed patients such as AIDS (acquired immunodeficiency syndrome). Frequently, lesions are located deep in the brain which are inaccessible for biopsy making rapid diagnosis dependent on accurate interpretation of neuroimaging findings. The commonest cranial CT findings reported in toxoplasmosis are ring enhancing hypodense lesions in basal ganglia or cortical gray matter. Hemorrhage has only rarely been described and is usually seen following antitoxoplasma treatment. We reviewed the records of 11 AIDS patients with cerebral toxoplasmosis and found multiple hemorrhagic cerebral, cerebellar, or brain stem lesions in 7 of 11 patients. Six patients had hemorrhage at the time of initial clinical presentation and one developed hemorrhage following 2 weeks of antitoxoplasma treatment. We conclude that hemorrhagic lesions are frequently found on cranial MRI scans in cerebral toxoplasmosis. AIDS patients presenting with hemorrhagic cerebral lesions should be considered for a trial of presumptive antitoxoplasma treatment. [source] Recombinant proteins in the diagnosis of toxoplasmosisAPMIS, Issue 8 2010DUPADAHALLI KOTRESHA Kotresha D, Rahmah N. Recombinant proteins in the diagnosis of toxoplasmosis. APMIS 2010; 118: 529,42. Toxoplasma gondii is an important human pathogen with a worldwide distribution. It is primarily of medical importance for pregnant women and immunocompromised patients. Primary infection of the former is often associated with fetal infection, which can lead to abortion or severe neonatal malformation. Immunocompromised patients are at risk of contracting the severe form of the disease that may be fatal. Thus, detection of T. gondii infection with high sensitivity and specificity is crucial in the management of the disease. Toxoplasmosis is generally diagnosed by demonstrating specific immunoglobulin M (IgM) and IgG antibodies to toxoplasma antigens in the patient's serum sample. Most of the commercially available tests use T. gondii native antigens and display wide variations in test accuracy. Recombinant antigens have great potential as diagnostic reagents for use in assays to detect toxoplasmosis. Thus in this review, we address recent advances in the use of Toxoplasma recombinant proteins for serodiagnosis of toxoplasmosis. [source] Potent Fluoro-oligosaccharide Probes of Adhesion in ToxoplasmosisCHEMBIOCHEM, Issue 15 2009Sarah A. Allman Abstract Unnatural, NMR- and MRI-active fluorinated sugar probes, designed and synthesised to bind to the pathogenic protein TgMIC1 from Toxoplasma gondii, were found to display binding potency equal to and above that of the natural ligand. Dissection of the binding mechanism and modes, including the first X-ray crystal structures of a fluoro-oligosaccharide bound to a lectin, demonstrate that it is possible to create effective fluorinated probe ligands for the study of, and perhaps intervention in, sugar,protein binding events. [source] Prevention of toxoplasmosis in transplant patientsCLINICAL MICROBIOLOGY AND INFECTION, Issue 12 2008F. Derouin Abstract Toxoplasmosis is a life-threatening opportunistic infection that affects haematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT) recipients. Its incidence in these patients is closely related to the prevalence of toxoplasmosis in the general population, which is high in Europe. In SOT recipients, toxoplasmosis results mainly from transmission of the parasite with the transplanted organ from a Toxoplasma -seropositive donor to a Toxoplasma -seronegative recipient. This risk is high in cases of transplantation of organs that are recognized sites of encystation of the parasite, e.g. the heart, and is markedly lower in other SOT recipients. Clinical symptoms usually occur within the first 3 months after transplantation, sometimes as early as 2 weeks post transplant, and involve febrile myocarditis, encephalitis or pneumonitis. In HSCT recipients, the major risk of toxoplasmosis results from the reactivation of a pre-transplant latent infection in seropositive recipients. The median point of disease onset is estimated at 2 months post transplant, with <10% of cases occurring before 30 days and 15,20% later than day 100. Toxoplasmosis usually manifests as encephalitis or pneumonitis, and frequently disseminates with multiple organ involvement. Diagnosis of toxoplasmosis is based on the demonstration of parasites or parasitic DNA in blood, bone marrow, cerebrospinal fluid, bronchoalveolar lavage fluid or biopsy specimens, and serological tests do not often contribute to the diagnosis. For prevention of toxoplasmosis, serological screening of donors and recipients before transplantation allows the identification of patients at higher risk of toxoplasmosis, i.e. seropositive HSCT recipients and mismatched (seropositive donor/seronegative recipients) SOT recipients. Preventing toxoplasmosis disease in those patients presently relies on prophylaxis via prescription of co-trimoxazole. [source] Fine-needle aspiration cytology of subcutaneous toxoplasmosis: A case reportDIAGNOSTIC CYTOPATHOLOGY, Issue 10 2010Xiaowei Chen M.D. Abstract Toxoplasmosis is a common opportunistic infection in patients with AIDS in whom it typically presents as encephalitis, pneumonia, lymphadenitis, and myocarditis. Skin involvement is very rare and, to our best knowledge, Toxoplasma gondii forming a subcutaneous mass has not been reported. Here, we report the findings of an interesting case of subcutaneous toxoplasmosis with the cytological appearance of an inflammatory fibrovascular lesion in a HIV-positive patient and discuss the differential diagnosis. Diagn. Cytopathol. 2010;38:716,720. © 2009 Wiley-Liss, Inc. [source] Pulmonary pathology in patients with AIDS: an autopsy study from MumbaiHIV MEDICINE, Issue 4 2001DN Lanjewar Objective Although India has a high prevalence of HIV/AIDS, the associated pathologies responsible for morbidity have not been evaluated previously in a representative study. Hence, an autopsy study was carried out to analyse the spectrum of pulmonary lesions in patients with HIV/AIDS. Methods A retrospective and prospective autopsy study was carried out during 1988,2000 at Mumbai, India. Lungs from 143 adults, with at least 10 sections from each case, were examined using routine and special stains. Results The risk factors for 97 men (68%) and 38 women (27%) included: heterosexual sex with multiple partners (135 cases, 95%); blood transfusions (three cases; 2%); sex between men (two cases; 1%); and unknown risk factors (three cases, 2%). Pulmonary pathology was observed in 126 (88%) cases. The lesions identified were tuberculosis (85 cases, 59%), bacterial pneumonia (26 cases, 18%), cytomegalovirus (CMV) infection (10 cases, 7%), cryptococcosis (eight cases, 6%), Pneumocystis carinii pneumonia (seven cases, 5%), aspergillosis (four cases, 3%), toxoplasmosis (two cases, 1%), Kaposi's sarcoma (one case, 1%), squamous cell carcinoma (one case, 1%). Two or more infections were observed in 18 (13%) cases. Conclusions Pulmonary diseases and risk factors among patients with AIDS in India differ from those reported in industrialized countries. Tuberculosis was the most frequently observed pulmonary infection, followed by bacterial pneumonia and CMV pneumonitis. In contrast with industrialized countries, PCP remains less common in our patients. The information on opportunistic infections obtained in this study will be useful for managing HIV/AIDS cases at district level hospitals where diagnosing specific HIV-associated diseases is not always possible. [source] Role of the Toll/interleukin-1 receptor signaling pathway in host resistance and pathogenesis during infection with protozoan parasitesIMMUNOLOGICAL REVIEWS, Issue 1 2004Ricardo T. Gazzinelli Summary:, Different studies have illustrated the activation of the innate immune system during infection with protozoan parasites. Experiments performed in vivo also support the notion that innate immunity has a crucial role in resistance as well as pathogenesis observed during protozoan infections such as malaria, leishmaniasis, toxoplasmosis, and trypanosomiasis. While major advances have been made in the assignment of bacterial molecules as Toll-like receptors (TLRs) agonists as well as defining the role of the Toll/interleukin-1 receptor (TIR) signaling pathway in host resistance to bacterial infection, this research area is now emerging in the field of protozoan parasites. In this review, we discuss the recent studies describing parasite molecules as TLR agonists and those studies indicating the essential role of the TIR-domain bearing molecule named myeloid differentiation factor 88 in host resistance to infection with protozoan parasites. Together, these studies support the hypothesis that the TIR signaling pathway is involved in the initial recognition of protozoan parasites by the immune system of the vertebrate host, early resistance to infection, development of acquired immunity, as well as pathology observed during acute infection with this class of pathogens. [source] BALB/c mice resistant to Toxoplasma gondii infection proved to be highly susceptible when previously infected with Myocoptes musculinus fur mitesINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 5 2007Áurea Welter Summary The immune response induced by Toxoplasma gondii is characterized by Th1 immune mechanisms. We previously demonstrated that C57BL/6 mice infested with Myocoptes musculinus and infected with T. gondii by intraperitoneal route undergo accelerated mortality according to Th2 immune mechanisms induced by the acarian. To evaluate whether infection with M. musculinus influences T. gondii -induced Th1 response in a resistant mouse lineage, BALB/c, which develops latent chronic toxoplasmosis in a way similar to that observed in immunocompetent humans, this study was done. The animals were infected with T. gondii ME-49 strain 1 month after M. musculinus infestation, being the survival and the immune response monitored. The double-infected displayed higher mortality rate if compared with the mono-infected mice. In addition, infection with M. musculinus changed the T. gondii -specific immune response, converting BALB/c host to a susceptible phenotype. Spleen cells had increased the levels of IL-4 in double-infected mice. This alteration was associated with severe pneumonia, encephalitis and wasting condition. In addition, a higher tissue parasitism was observed in double-infected animals. It can be concluded that infection with these two contrasting parasites, M. musculinus and T. gondii, may convert an immunocompetent host into a susceptible one, and such a host will develop severe toxoplasmosis. [source] Eccentric target sign in cerebral toxoplasmosis: Neuropathological correlate to the imaging feature,JOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 6 2010G.G. Sharath Kumar MD Abstract Cerebral toxoplasmosis remains one of the most common focal brain lesions in patients with acquired immune deficiency syndrome (AIDS). Diagnosis is a challenge because on cranial imaging it closely mimics central nervous system lymphoma, primary and metastatic central nervous system (CNS) tumors, or other intracranial infections like tuberculoma or abscesses. A magnetic resonance imaging (MRI) feature on postcontrast T1-weighted sequences considered pathognomonic of toxoplasmosis is the "eccentric target sign." The pathological correlate of this imaging sign has been speculative. Herein we correlate the underlying histopathology to the MR feature of eccentric target sign in a patient with autopsy-proven HIV/AIDS-related cerebral toxoplasmosis. The central enhancing core of the target seen on MRI was produced by a leash of inflamed vessels extending down the length of the sulcus that was surrounded by concentric zones of necrosis and a wall composed of histiocytes and proliferating blood vessels, with impaired permeability producing the peripheral enhancing rim. J. Magn. Reson. Imaging 2010;31:1469,1472. © 2010 Wiley-Liss, Inc. [source] Atypical imaging appearance of toxoplasmosis in an HIV patient as a butterfly lesionJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 4 2009Vinika V. Chaudhari MD Abstract In acquired immunodeficiency syndrome (AIDS) patients, differentiating toxoplasmosis and primary central nervous system (CNS) lymphoma remains a clinical and radiographic dilemma. The presence of butterfly lesions crossing the corpus callosum is customarily used to exclude the possibility of toxoplasmosis. We present an AIDS patient who had Epstein-Barr virus (EBV) polymerase chain reaction (PCR) -positive cerebrospinal fluid studies with a butterfly toxoplasmosis lesion confirmed by multiple methods signifying the importance of including toxoplasmosis in the differential diagnosis of butterfly lesions. J. Magn. Reson. Imaging 2009;30:873,875. © 2009 Wiley-Liss, Inc. [source] Frequent Hemorrhagic Lesions in Cerebral Toxoplasmosis in AIDS PatientsJOURNAL OF NEUROIMAGING, Issue 2 2009Satyakam Bhagavati MD ABSTRACT Cerebral toxoplasmosis is a frequent complication in immunosuppressed patients such as AIDS (acquired immunodeficiency syndrome). Frequently, lesions are located deep in the brain which are inaccessible for biopsy making rapid diagnosis dependent on accurate interpretation of neuroimaging findings. The commonest cranial CT findings reported in toxoplasmosis are ring enhancing hypodense lesions in basal ganglia or cortical gray matter. Hemorrhage has only rarely been described and is usually seen following antitoxoplasma treatment. We reviewed the records of 11 AIDS patients with cerebral toxoplasmosis and found multiple hemorrhagic cerebral, cerebellar, or brain stem lesions in 7 of 11 patients. Six patients had hemorrhage at the time of initial clinical presentation and one developed hemorrhage following 2 weeks of antitoxoplasma treatment. We conclude that hemorrhagic lesions are frequently found on cranial MRI scans in cerebral toxoplasmosis. AIDS patients presenting with hemorrhagic cerebral lesions should be considered for a trial of presumptive antitoxoplasma treatment. [source] In situ assays demonstrate that interferon-gamma suppresses infection-stimulated hepatic fibrin deposition by promoting fibrinolysisJOURNAL OF THROMBOSIS AND HAEMOSTASIS, Issue 7 2006I. K. MULLARKY Summary.,Background:,Inflammatory cytokines potently impact hemostatic pathways during infection, but the tissue-specific regulation of coagulation and fibrinolysis complicates studies of the underlying mechanisms. Methods and Results:,Here, we describe assays that quantitatively measuring prothrombinase (PTase), protein C-ase (PCase) and plasminogen activator (PA) activities in situ, thereby facilitating studies of tissue-specific hemostasis. Using these assays, we investigate the mechanisms regulating hepatic fibrin deposition during murine toxoplasmosis and the means by which interferon-gamma (IFN- ,) suppresses infection-stimulated fibrin deposition. We demonstrate that Toxoplasma infection upregulates hepatic PTase, PCase, and PA activity. Wild type and gene-targeted IFN- , -deficient mice exhibit similar levels of infection-stimulated PTase activity. By contrast, IFN- , -deficiency is associated with increased PCase activity and reduced PA activity during infection. Parallel analyses of hepatic gene expression reveal that IFN- , -deficiency is associated with increased expression of thrombomodulin (TM), a key component of the PCase, increased expression of thrombin-activatable fibrinolysis inhibitor (TAFI), a PC substrate, and reduced expression of urokinase PA (u-PA). Conclusions:,These findings suggest that IFN- , suppresses infection-stimulated hepatic fibrin deposition by suppressing TM-mediated activation of TAFI, thereby destabilizing fibrin deposits, and concomitantly increasing hepatic u-PA activity, thereby promoting fibrinolysis. We anticipate that further application of these in situ assays will improve our understanding of tissue-specific hemostasis, its regulation by cytokines, and its dysregulation during coagulopathy. [source] Progress in type II dehydroquinase inhibitors: From concept to practiceMEDICINAL RESEARCH REVIEWS, Issue 2 2007Concepción González-Bello Abstract Scientists are concerned by an ever-increasing rise in bacterial resistance to antibiotics, particularly in diseases such as malaria, toxoplasmosis, tuberculosis, and pneumonia, where the currently used therapies become progressively less efficient. It is therefore necessary to develop new, safe, and more efficient antibiotics. Recently, the existence of the shikimic acid pathway has been demonstrated in certain parasites such as the malaria parasite. These types of parasites cause more than a million casualties per year, and their effects are particularly strong in people with a compromised immune system such as HIV patients. In such cases it is possible that inhibitors of this pathway could be active against a large variety of microorganisms responsible for the more opportunistic infections in HIV patients. Interest in this pathway has resulted in the development of a wide variety of inhibitors for the enzymes involved. This review covers recent progress made in the development of inhibitors of the third enzyme of this pathway, i.e., the type II dehydroquinase. The X-ray crystal structures of several dehydroquinases (Streptomyces coelicolor, Mycobacterium tuberculosis, etc.) with an inhibitor bound in the active site have recently been solved. These complexes identified a number of key interactions involved in inhibitor binding and have shed light on several aspects of the catalytic mechanism. These crystal structures have also proven to be a useful tool for the design of potent and selective enzyme inhibitors, a feature that will also be discussed. © 2006 Wiley Periodicals, Inc. Med Res Rev [source] Progressive multifocal leukencephalopathy and cerebral toxoplasmosis in a patient with CLL,AMERICAN JOURNAL OF HEMATOLOGY, Issue 8 2010Ronan Desmond No abstract is available for this article. [source] Congenital toxoplasmosis: late pregnancy infections detected by neonatal screening and maternal serological testing at deliveryPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 6 2007Eleonor G. Lago Summary The first aim of this study was to determine the prevalence of congenital toxoplasmosis in newborn infants treated by the public health system in Porto Alegre, a city in southern Brazil, using neonatal screening for Toxoplasma gondii -specific IgM. The second aim was to investigate whether the cases detected by this approach could have been identified by the prenatal screening for antibodies to T. gondii that was performed in the same population. A fluorometric assay was used to analyse T. gondii -specific IgM in filter paper specimens obtained from newborn infants for routine screening for metabolic diseases. When the specific IgM was positive, serum samples from the infant and the mother were requested for confirmatory serological testing, and the infant underwent clinical examination. Among 10 000 infants screened for T. gondii -specific IgM, seven filter paper samples were positive, and congenital toxoplasmosis was confirmed in six patients. The prevalence of IgM specific for T. gondii was 6/10 000 [95% CI 2/10 000, 13/10 000]. One infected infant had already been identified in the maternity ward before birth, three had been identified by maternal serology at delivery, and two infants with congenital toxoplasmosis were identified solely through neonatal screening. Although four mothers of the patients with congenital toxoplasmosis received prenatal care, and three mothers had one or two serological tests for T. gondii -specific antibodies (one at first trimester, one at first and second trimesters, and the other at second and third trimesters), they were not identified during pregnancy as infected. Neonatal screening identified cases of infection not detected by obtaining only one or two serum samples from pregnant women for T. gondii serology, mainly when infection was acquired and transmitted in late pregnancy. Maternal serology at delivery and neonatal screening were especially useful in the identification of infants with congenital toxoplasmosis when the mother did not receive regular prenatal serological testing or prenatal care. [source] GRA7 provides protective immunity in cocktail DNA vaccines against Toxoplasma gondiiPARASITE IMMUNOLOGY, Issue 9 2007E. JONGERT SUMMARY In a previous study, single-gene vaccination with GRA1, GRA7 or ROP2 was shown to elicit partial protection against Toxoplasma gondii. In this study, the contribution of each antigen in the evoked humoral and cellular immune responses was evaluated after vaccination with plasmid mixtures containing GRA1, GRA7 and ROP2. Cocktail DNA vaccinated mice developed high antibody titers against the antigens from two-gene DNA vaccine cocktails, but lower titres when immunized with the three-gene cocktail. High numbers of IFN-, secreting splenocytes were generated predominantly against GRA7. Brain cyst burden was reduced by 81% in mice vaccinated with the three-gene mixture and they were completely protected against acute toxoplasmosis. Similar high levels of brain cyst reductions were obtained after vaccination with cocktails composed of GRA1 and GRA7 (89% reduction), or GRA7 and ROP2 (79% reduction), but not with the cocktail composed of GRA1 and ROP2. In low dose single-gene vaccinations, IFN-, and strong protection could only be elicited by GRA7. Hence, the presence of GRA7 in the DNA vaccine formulation was important for optimal protection and this was correlated with GRA7-specific IFN-, production. We propose GRA7 as a main component in cocktail DNA vaccines for vaccination against T. gondii. [source] Ocular toxoplasmosis: in the storm of the eyePARASITE IMMUNOLOGY, Issue 12 2006L. A. JONES SUMMARY Ocular toxoplasmosis (OT) can occur in the children of mothers infected with Toxoplasma gondii during pregnancy. It is not limited to the congenitally infected, but can also occur following adult-acquired infection or as a result of disease reactivation in immune-compromised and pregnant individuals. Many aspects of immune privilege in the eye, including constitutive TGF-, expression and reduced MHC class 1 expression, would appear at first to favour parasite survival. Conversely, many of the mechanisms that control parasite multiplication in other anatomical sites, such as nitric oxide expression, IFN-, and TNF-,, are known to disrupt immune privilege and are associated with ocular damage. Taking into account the opposing needs of limiting parasite multiplication and minimizing tissue destruction we review the pathogenesis of OT in the murine model. [source] Prenatal screening and diagnosis of congenital toxoplasmosis: a review of safety issues and psychological consequences for women who undergo screeningPRENATAL DIAGNOSIS, Issue 5 2007Babak Khoshnood Abstract As part of the EUROTOXO initiative, this review focuses on the potential risks associated with prenatal testing for congenital toxoplasmosis. We first review the evidence on the risks of adverse events associated with amniocentesis, which is required for definitive diagnosis of toxoplasmosis infection in the fetus, and for which the most important risk is fetal loss. To date, there has been only one randomized trial to document risks associated with amniocentesis. This trial, which was conducted in 1986, reported a procedure-related rate of fetal loss of 1.0% (95% CI, 0.3,1.5). However, evidence from available controlled studies suggests that the pregnancy loss associated with mid-trimester amniocentesis may be lower. Potential psychological consequences of prenatal testing for congenital toxoplasmosis include parental anxiety due to false positive results and uncertainties related to prognosis of children with a prenatal diagnosis of congenital toxoplasmosis. Parental anxiety may be particularly important in screening strategies that include more frequent screenings, which may in turn entail substantial, and at times unnecessary, anxiety or other negative consequences for women and their families. These negative psychological outcomes should be balanced against the benefits of testing, which can allow women to make an informed choice regarding the pregnancy. Copyright © 2007 John Wiley & Sons, Ltd. [source] The History of Toxoplasma gondii,The First 100 YearsTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 6 2008JITENDER P. DUBEY ABSTRACT. In this paper the history of Toxoplasma gondii and toxoplasmosis is reviewed. This protozoan parasite was first discovered in 1908 and named a year later. Its medical importance remained unknown until 1939 when T. gondii was identified in tissues of a congenitally infected infant, and veterinary importance became known when it was found to cause abortion storms in sheep in 1957. The discovery of a T. gondii specific antibody test, Sabin,Feldman dye test in 1948 led to the recognition that T. gondii is a common parasite of warm-blooded hosts with a worldwide distribution. Its life cycle was not discovered until 1970 when it was found that felids are its definitive host and an environmentally resistant stage (oocyst) is excreted in feces of infected cats. The recent discovery of its common infection in certain marine wildlife (sea otters) indicates contamination of our seas with T. gondii oocysts washed from land. Hygeine remains the best preventive measure because currently there is no vaccine to prevent toxoplasmosis in humans. [source] Recombinant proteins in the diagnosis of toxoplasmosisAPMIS, Issue 8 2010DUPADAHALLI KOTRESHA Kotresha D, Rahmah N. Recombinant proteins in the diagnosis of toxoplasmosis. APMIS 2010; 118: 529,42. Toxoplasma gondii is an important human pathogen with a worldwide distribution. It is primarily of medical importance for pregnant women and immunocompromised patients. Primary infection of the former is often associated with fetal infection, which can lead to abortion or severe neonatal malformation. Immunocompromised patients are at risk of contracting the severe form of the disease that may be fatal. Thus, detection of T. gondii infection with high sensitivity and specificity is crucial in the management of the disease. Toxoplasmosis is generally diagnosed by demonstrating specific immunoglobulin M (IgM) and IgG antibodies to toxoplasma antigens in the patient's serum sample. Most of the commercially available tests use T. gondii native antigens and display wide variations in test accuracy. Recombinant antigens have great potential as diagnostic reagents for use in assays to detect toxoplasmosis. Thus in this review, we address recent advances in the use of Toxoplasma recombinant proteins for serodiagnosis of toxoplasmosis. [source] A prospective study of diagnosis of Toxoplasma gondii infection after bone marrow transplantation,APMIS, Issue 5 2008BENJAMIN EDVINSSON Active infection with Toxoplasma gondii in immunocompromised transplant recipients can lead to toxoplasmosis, which may have a rapid disease course and in some cases be fatal. It is of paramount importance to diagnose toxoplasmosis at an early stage, and to initiate specific treatment to improve the outcome. Polymerase chain reaction (PCR) is today the primary diagnostic tool to diagnose toxoplasmosis in immunocompromised patients. Timely diagnosis may, however, be difficult if toxoplasmosis is at first asymptomatic. To investigate the magnitude of toxoplasmosis after bone marrow transplantation (BMT), we conducted a screening study by PCR where 21 autologous and 12 allogeneic BMT recipients were included. Peripheral blood samples were taken one week prior to BMT; thereafter, blood samples were drawn weekly for the first 6 months, and monthly up to one year after BMT. The samples were analyzed by conventional PCR and real-time PCR. T. gondii DNA was detected in peripheral blood from one patient 5 days post allogeneic BMT. There were no clinical signs of toxoplasmosis. Medical records were reviewed and showed a previously undiagnosed eye infection in another allogeneic BMT recipient. These two patients were seropositive for T. gondii. We concluded that monitoring for T. gondii DNA in peripheral blood samples using PCR might be a valuable method for identifying toxoplasma-seropositive stem cell transplant recipients. [source] Antenatal screening practice for infectious diseases by general practitioners in AustraliaAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2009Michelle L. GILES Introduction:, This study aimed to assess self-reported screening practice in the antenatal setting, factors associated with screening, barriers to universal testing for HIV and follow-up for infants born to hepatitis C virus (HCV)-infected women. Methods:, A total of 3100 general practitioners (GPs) were mailed the survey. The half from Victoria was randomised to receive their questionnaire by registered post or regular post. All GPs from New South Wales (NSW) received their questionnaire via regular post. Results:, The overall response rate was 70%. Registered post resulted in a higher cumulative response rate compared with regular post (86% vs. 67%P < 0.001). Greater than 90% of respondents always screened for syphilis, rubella and hepatitis B virus. Testing for HIV and HCV approached 66% in NSW. In Victoria more respondents always screen for HCV (72%) compared with HIV-1 (64%). Respondents from NSW were less likely to screen for toxoplasmosis (adjusted odds ratio (AOR) 0.64 (0.43, 0.94) P = 0.02) or HCV (AOR 0.75 (0.61, 0.92) P = 0.005) compared with Victoria. Older respondents were more likely to screen for toxoplasmosis (AOR 1.54 (1.05, 2.27) P = 0.03), cytomegalovirus (OR 1.5 (1.0, 2.1) P = 0.05) and chlamydia (AOR 1.88 (1.27, 2.77) P = 0.002). Of respondents who have managed a pregnant woman with HCV 25% inappropriately test infants for infection before one month of age. Conclusion:, This study highlights the need for more education and resources to increase HIV testing rates and to improve follow-up of an HCV-exposed infant. [source] Prediction of congenital toxoplasmosis by polymerase chain reaction analysis of amniotic fluidBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 5 2005L. Thalib Objective To determine the accuracy of polymerase chain reaction (PCR) analysis of amniotic fluid for fetal toxoplasmosis according to clinical predictors of outcome and study centre. Design Prospective cohort study. Setting Nine European centres. Population Women with suspected toxoplasma infection identified by prenatal screening. Methods Logistic regression was used to examine the effects of gestational age at maternal seroconversion, treatment and timing of amniocentesis, on PCR accuracy, and to calculate the post-test probability of congenital toxoplasmosis. Main outcome measures Infants had congenital toxoplasmosis if specific IgG persisted beyond 11.5 months. Uninfected infants had undetectable IgG in the absence of anti-toxoplasma treatment. Results Of 593 PCR results, 64 were positive (57 confirmed infected), and 529 were negative (23 confirmed infected). The likelihood ratio for a positive PCR result decreased significantly with trimester at seroconversion, but did not change significantly for a negative result. Weak associations were detected between sensitivity and, inversely, with specificity, and gestational age at maternal seroconversion. There was no significant association between sensitivity and centre, type or duration of treatment, or timing of amniocentesis. Specificity differed significantly between centres (P < 0.001). The change in pre- to post-test probability of infection was maximal for a positive PCR after first trimester seroconversion, affecting 1% of women tested, and a negative PCR after third trimester seroconversion, affecting half the women tested. Conclusions Prediction of the risk of congenital toxoplasmosis should combine estimates of test accuracy and maternal,fetal transmission, which take account of the gestational age at which the mother seroconverted. Local laboratory standards will affect the generalisability of these results. [source] Cerebral toxoplasmosis in a patient with chronic lymphocytic leukaemia treated with fludarabineBRITISH JOURNAL OF HAEMATOLOGY, Issue 3 2007S. Bacchu No abstract is available for this article. [source] 4151: Epidemiology of uveitis in the Middle East and North AfricaACTA OPHTHALMOLOGICA, Issue 2010M KHAIRALLAH Purpose Numerous studies have examined the pattern of uveitis around the world. Most of them are from western countries, including the USA and countries in Europe, and Eastern Asia. The aim of this presentation is to review the epidemiological characteristics of uveitis in the the Middle East and North Africa. Methods The epidemiologic data on uveitis available from the Middle East and North Africa were reviewed. Results Several recent studies addressed the pattern of uveitis in different countries, including Iran, Saudi Arabia, Turkey, and Tunisia. Uveitis was most often seen in adults with a peak age at presentation in the third and fourth decades. There was no dramatic difference in gender distribution. Anterior uveitis was the most common anatomic form of uveitis, but a high rate of posterior uveitis and panuveitis was reported. A definitive or presumed specific diagnosis could be established for 57-87% of patients. The most common infectious entities were herpetic anterior uveitis, toxoplasmosis, and tuberculosis (Saudi Arabia). The most common identifiable non-infectious entities included Behçet's disease and Vogt-Koyanagi-Harada disease. Conclusion Herpetic infection, toxoplasmosis, and tuberculosis are the most common infectious causes of uveitis in the Middle East and North Africa. Behçet's diease and Vogt-Koyanagi-Harada disease are the most common non-infectious uveitic entities.HLA-B27 acute anterior uveitis, ocular sarcoidosis, and juvenile idiopathic arthritis associated uveitis are less common than in western countries. [source] 4154: Infectious uveitis (toxoplasmosis, herpes and others)ACTA OPHTHALMOLOGICA, Issue 2010M KHAIRALLAH [source] Intravitreal bevacizumab for choroidal neovascularization in toxoplasmosisACTA OPHTHALMOLOGICA, Issue 6 2009Rainer Guthoff No abstract is available for this article. [source] Ocular toxoplasmosis recurrences: a single center case reportACTA OPHTHALMOLOGICA, Issue 2009U SERRA Purpose To describe recurrence patterns in a cohort of patients with aqueous humor proven ocular toxoplasmosis, followed during 3 years, at a single referral center. Methods Retrospective, observational, non comparative case series including 43 patients who suffered from an active episode of toxoplasmic retinochoroiditis during 2005, confirmed by aqueous humour polymerase chain reaction (PCR) positivity and assisted at the Ophthalmology Department of the Pitié-Salpêtrière Hospital in Paris, France. Clinical files were analyzed in terms of signs of intraocular inflammation, number, size and location of retinochoroidal active lesions and scars, presence of ocular complications related to toxoplasmic retinochoroiditis, angiographic and visual field findings and therapeutic management. Results 20 males and 23 females (mean age 37 year-old) were followed after an episode of toxoplasmic retinochoroiditis confirmed by analysis of ocular fluids. Five of them were immunocompromised and twelve have already experienced at least a previous episode of active toxoplasmic retinochoroiditis. Recurrences occurred in 13 patients (28%) with a mean age of 48 years. These episodes were noted during the first year of follow-up, between 12 and 24 months and between 24 and 36 months in 4, 5 and 3 patients respectively. Conclusion Recurrences seem to be more frequent if they occur during the first year after the initial episode of retinochoroiditis, especially in older patients. Prospective studies are needed in order to confirm these preliminary data. [source] Expression of interleukin-6, tumour necrosis factor-, and nitric oxides during episodes of ocular toxoplasmosis in an HIV patientACTA OPHTHALMOLOGICA, Issue 8 2007Javier Prada No abstract is available for this article. [source] | |||||||||||||||||||||||||||||||