Toxoplasmosis

Abstract

Toxoplasma gondii is a worldwide zoonotic infection. The sexual cycle occurs only in the cat family; only the cat's faeces are infectious, but cysts in animals and birds can cause infection when these are consumed. Acquired acute Toxoplasma infection can be asymptomatic or have nonspecific, flu-like symptoms. Lymphadenopathy is the most recognized presentation and may last more than 6 months. Retinochoroiditis is usually a result of reactivated congenital infection. Increasingly recognized is chronic infection producing chronic fatigue syndrome. Reactivated infections, particularly in the immunocompromised, are a major problem and prophylaxis may be required. Toxoplasma status should also be determined before transplantation. Laboratory diagnosis depends on the presence of specific IgM or IgA, and by increases in specific IgG. Diagnosis may require Western blotting or polymerase chain reaction analysis. First-line treatment is pyrimethamine, sulfadiazine and folinic acid. Other drugs (clindamycin, clarithromycin, azithromycin or atovaquone) can be helpful.