Toxoplasmosis

"Toxoplasmosis is especially dangerous in patients affected by AIDS, corticotherapy or lymphomas".

DR. ALMUDENA BELTRÁN DE MIGUEL
SPECIALIST. INTERNAL MEDICINE DEPARTMENT

Toxoplasmosis is the disease produced by Toxoplasma Gondii infection.

This is a forced intracellular parasite that has a complex life cycle in which man (along with other animals: pigs; birds; sheep...) participates as an intermediate host; being the cat and other felines, the definitive host.

Coinciding with the primoinfection there is an acute phase of the disease where the division of the parasite is rapid (the so-called tachyzoites) and which triggers the activation of the immune system, which if effective will manage to control the infection with the consequent formation, in the affected tissues, of cysts containing parasites of very slow division (the so-called bradyzoites). This is the chronic phase.

People who are HIV positive have a special risk of contracting the disease. Pregnant women must also be careful because the pathology can seriously affect the fetus.

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What are the symptoms of toxoplasmosis?

We can divide the total number of patients with toxoplasmosis into four groups:

Intact immune system: Most of them are usually asymptomatic and self-limited. Only a small percentage of patients have fever, malaise, fatigue and most often the appearance of nodes in the cervical region. These symptoms resolve in several weeks, except for adenopathy, which can persist for several months.

Immunosuppression: In most cases it is a reactivated infection and usually presents general symptoms and especially of the central nervous system as hemiplegia, hemiparesis, disorders of walking and balance ... sometimes fatal.

Ocular Toxoplasmosis: Usually manifests itself as chorioretinitis and in most cases is the result of a congenital infection. The symptoms are blurred vision, eye pain, photophobia.

Congenital Toxoplasmosis: Consequence of a primoinfection in the pregnant woman. It can be evident already at birth with neurological alterations, skin lesions, enlargement of the liver and spleen; or it can take months or even years to appear. Hence the importance of screening studies in pregnant women.

The most common symptoms are:

  • Hemiplegia.
  • Disorders of walking and balance.
  • Blurred vision.
  • Ocular pain.

Do you have any of these symptoms?

You may have a toxoplasmosis

What are the causes of toxoplasmosis?

The most frequent form of infection is the ingestion of meat with bradyzoite cysts, but it can also be infected with cysts that eliminate cats in their feces. It is also possible to be infected by transfusions or organ transplants from infected patients.

Once inside the body, bradyzoites are transformed into tachyzoites that penetrate mainly into cells of the skeletal muscle, heart, lymphatic tissue, brain, retina and placenta, where they divide at great speed and cause the appearance of the symptoms of the disease. This will have been controlled once the transformation of tachycysts into bradyzoites and the appearance of cysts is achieved.

What is your prognosis?

The risk of primary infection can be reduced by avoiding eating undercooked meat (heating it up to 60º) or by freezing the food correctly. Fruits and vegetables should be washed properly.

Pregnant women with negative antibodies to the parasite should seek testing for infection several times during pregnancy if they are exposed to conditions that increase the chance of infection.

How is toxoplasmosis diagnosed?

<p>Laboratorio de extracciones</p>

Since most of the times the symptoms do not exist or are not very specific, the diagnosis is based on the study of the antibodies produced against the parasite (IgM and IgG) and the detection of the same.

However, the diagnostic method must be adapted to the clinical context of the patient under study. In the immunocompetent patient, it is mainly serological, whereas in immunosuppressed patients, it is the clinical priority to establish the treatment, reserving the biopsy for cases of inefficiency.

In newborns the clinic and antibodies are useful but it is necessary the isolation or detection of the parasite in the tissues.

Any alteration in the immune system (AIDS, corticotherapy, lymphomas) can trigger a reactivation of the disease.

How is toxoplasmosis treated?

Although there are numerous drugs available, the treatment of choice is the combination of pyrimethamine with sulfadiazine, which is able to control the rapid replication phase (acute phase of the disease), but nevertheless does not act on the cysts.

Against these, treatments with hydroxynaphoquinone (atovaquone) and azithromycin appear to be very useful.

Where do we treat it?

IN NAVARRA AND MADRID

The Infectious Diseases Service
of the Clínica Universidad de Navarra

This area works on the diagnosis and treatment of diseases produced by an infectious agent, which can be bacteria, virus, fungus and protozoa. Infections affect people by causing very different processes that can be located in any tissue of the human body, so it requires a specific approach.

This area carries out its activity on three fronts: care work, focused on the diagnosis and treatment of infectious diseases; teaching, with training of medical students, resident doctors and nurses; and research vocation, through the development of clinical and laboratory studies.

Organized in care units

  • Infections associated with biomaterials.
  • Nosocomial infections (multi-resistance).
  • Infections in immunosuppressed patients.
  • Community infection.
  • Traveler's medicine.
  • Prudent use and optimization program of anti-infective therapy.
  • Control of infection by multi-resistant microorganisms.
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Why at the Clinica?

  • We perform the traveler's assessment and analytical tests in less than 24 hours.
  • Second opinion consultation when the infection has not yet been resolved.
  • We ensure the prudent use of antibiotics.

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