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      Toxoplasmosis: A Global Threat

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          Abstract

          Toxoplasmosis, a disease described worldwide, which is caused by the protozoan Toxoplasma gondii, commonly involves the retina. The disease has a higher impact in immunocompromised individuals and in congenital infection because of the severity of central nervous system involvement. Although simple prophylactic measures could reduce transmission, T. gondii seroprevalence is still high, especially in South America. Educational campaigns and the development of new drugs to prevent primary infection could potentially reduce the burden of the disease.

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          Toxoplasmic encephalitis in AIDS.

          B. J. Luft, J Remington (1992)
          Involvement of the central nervous system (CNS) is common in patients with advanced disease due to human immunodeficiency virus (HIV). Symptoms range from lethargy and apathy to coma, incoordination and ataxia to hemiparesis, loss of memory to severe dementia, and focal to major motor seizures. Involvement may be closely associated with HIV infection per se, as in the AIDS dementia complex, but is frequently caused by opportunistic pathogens such as Toxoplasma gondii and Cryptococcus neoformans or malignancies such as primary lymphoma of the CNS. The clinical presentations of attendant and direct CNS involvement are remarkably non-specific and overlapping, yet a correct diagnosis is critical to successful intervention. Toxoplasmic encephalitis is one of the most common and most treatable causes of AIDS-associated pathology of the CNS. A great deal has been learned in the last 10 years about its unique presentation in the HIV-infected patient with advanced disease. Drs. Benjamin J. Luft of the State University of New York at Stony Brook and Jack S. Remington of the Stanford University School of Medicine and Palo Alto Medical Foundation's Research Institute have studied T. gondii for many years and are two of the leading experts in the field. This commentary comprises an update of their initial review (J Infect Dis 1988;157:1-6) and a presentation of the current approaches to diagnosing and managing toxoplasmic encephalitis in HIV-infected patients.
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            Management of Toxoplasma gondii infection during pregnancy.

            Jose G Montoya, Jack Remington (2008)
            Acute infection with Toxoplasma gondii during pregnancy and its potentially tragic outcome for the fetus and newborn continue to occur in the United States, as well as worldwide, despite the fact that it can be prevented. The infection can be acquired through ingestion of infected, undercooked meat or contaminated food or water. Transmission to the fetus occurs almost solely in women who acquire their primary infection during gestation and can result in visual and hearing loss, mental and psychomotor retardation, seizures, hematological abnormalities, hepatosplenomegaly, or death. Systematic education and serological screening of pregnant women are the most reliable and currently available strategies for the prevention, diagnosis, and early treatment of the infection in the offspring; this is largely because toxoplasmosis in pregnant women most often goes unrecognized. Treatment of the infection in the fetus and infant during the first year of life has been demonstrated to significantly improve the clinical outcome.
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              An unusually high prevalence of ocular toxoplasmosis in southern Brazil.

              Fernando Silveira, Alice Martins, D. Moran … (1992)
              Because of the frequency of ocular toxoplasmosis and its occurrence in multiple siblings in southern Brazil, a population-based household survey was performed to better understand the epidemiologic characteristics of the disease in this region. Of 1,042 individuals examined, 184 (17.7%) were deemed to have ocular toxoplasmosis on the basis of conservative assessment of ophthalmic findings. Of those with ocular toxoplasmosis, 183 (99.5%) had specific IgG antibodies, compared with only 140 of 181 age-matched control subjects (77.4%; P less than .001). The prevalence of ocular toxoplasmosis was 0.9% in 1- to 8-year-olds, 4.3% in 9- to 12-year-olds, 14.3% in 13- to 16-year-olds, and 21.3% (95% confidence interval, 18.6% to 24.2%) in all individuals 13 years or older. The prevalence of ocular toxoplasmosis in this population was more than 30 times higher than previous estimates for the same condition elsewhere. The low prevalence in the young children we studied supplements previous data suggesting that, in this population, ocular toxoplasmosis is a sequela of postnatal rather than congenital infection.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Glob Infect Dis
                Journal ID (publisher-id): JGID
                Title: Journal of Global Infectious Diseases
                Publisher: Medknow Publications (India )
                ISSN (Print): 0974-777X
                ISSN (Electronic): 0974-8245
                Publication date (Print): Jul-Sep 2011
                Volume: 3
                Issue: 3
                Pages: 281-284
                Affiliations
                [1] Casey Eye Institute, Division of International Ophthalmology, Oregon Health & Science University, Portland, Oregon
                [1 ] Casey Eye Institute and Departments of Cell and Developmental Biology, Oregon Health & Science University, Portland, Oregon
                [2 ] Department of Ophthalmology, Federal University of São Paulo, Brazil
                Author notes
                Address for correspondence: Dr. J M Furtado, E-mail: furtado@ 123456ohsu.edu
                Article
                Publisher ID: JGID-3-281
                DOI: 10.4103/0974-777X.83536
                PMC ID: 3162817
                PubMed ID: 21887062
                SO-VID: 2f4dd3c0-64e3-48b5-a065-7d19e0a641e0
                Copyright © © Journal of Global Infectious Diseases
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Subject: Symposium

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: ocular toxoplasmosis,toxoplasmic encephalitis,congenital toxoplasmosis
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: ocular toxoplasmosis, toxoplasmic encephalitis, congenital toxoplasmosis

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