Toxoplasmosis

April 2017


Definition


Toxoplasmosis is a parasitic infection, transmissible from animals (zoonosis), especially cats. The cat becomes infected with the parasite Toxoplasma gondii, which can be transmitted to humans. In the vast majority of cases, toxoplasmosis is harmless, and is at most responsible for a trivial transient infection, but it can pose a significant threat to people with weakened immune systems or to the fetus during pregnancy.

Symptoms


Most of the time, an immunocompetent person will have no symptoms, but in some cases, the infection can manifest itself as mononucleosis:
  • swollen glands;
  • Fever;
  • fatigue.

These symptoms usually disappear after a few weeks without treatment.
In the case of immunocompromised individuals, and mainly those with AIDS, severe forms may arise, including cerebral toxoplasmosis. This is manifested by fever and neurological signs such as sensory motor deficits, paralysis and brutal movements reminiscent of epilepsy ...
Also, when the disease affects the fetus via transmission from the mother, complications may occur: this is called congenital toxoplasmosis. Malformations are more serious if congenital toxoplasmosis occurs in early pregnancy. The risk of transmission to the fetus is lower at this time but the defects are less severe late in pregnancy when transmission is more common.

Diagnosis


In adults, serology for toxoplasmosis, highlighting the characteristics of the parasite antibodies, is possible. In cases of cerebral toxoplasmosis in the immunocompromised person, imaging or an MRI will search for images of brain abscess, single or more often multiple in number. In pregnant women, serology is systematically practiced in those with weakened immune systems, and various tests look to see if the infection has been transmitted to the fetus.

Treatment


In the case of the presence of the disease in immunocompetent individuals, healing will usually occur within a few weeks without any treatment.
In immunocompromised individuals, different antibiotics are given for 6 weeks. Lastly, in pregnant women, treatment by spiramycin in necessary, when serology shows a recent infection and if the testing of the fetus is negative, a simple ultrasound and serological surveillance is undertaken monthly. In case of positive tests, treatment is continued until the end of pregnancy if the ultrasound is normal. A medical abortion can be performed otherwise.

Prevention


To prevent toxoplasmosis in pregnant women or immunocompromised individuals, it is advisable to eat only well-cooked meat, wash fruits and vegetables and peel them, wash your hands regularly, especially after handling food, and avoid contact with cats or cat litter. Moreover, in the person with AIDS whose CD4 cell count is too low, the same drugs for therapy are given, but at lower doses. Lastly, in pregnant women, toxoplasmosis serology is mandatory in early pregnancy and if the patient is not immune, monthly monitoring is essential.

Related

Original article published by . Translated by Jeff. Latest update on July 23, 2013 at 12:31 PM by Jeff.
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