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Toxoplasmosis is a disease caused by infection with the Toxoplasma gondii parasite, one of the most widespread parasites on the planet. Infection mainly arises as a result of eating undercooked contaminated meat, coming into contact with infected cat feces, or mother-to-child transmission during pregnancy.
Toxoplasmosis can induce flu-like symptoms in some people, although the vast majority of people who are infected never show any signs or symptoms. Toxoplasmosis can be fatal in newborns born to infected mothers and in those with weaker immune systems.
If you are otherwise healthy, not pregnant, and have been diagnosed with toxoplasmosis, you will most likely not require any therapy other than cautious care. If you are pregnant or have a weakened immune system, you may require medical attention to avoid serious problems. However, prevention is the best strategy.
WHAT ARE THE SYMPTOMS OF TOXOPLASMOSIS?
Most healthy persons who have toxoplasmosis have no symptoms and are unaware that they are afflicted. Some patients, however, experience flu-like symptoms, including:
- Body aches
- Swollen lymph nodes
- Headache
- Fever
- Fatigue
In people with weakened immune systems
A past toxoplasma infection may recur if you have HIV/AIDS, are getting chemotherapy, or have recently undergone an organ transplant. In that situation, you may experience more severe infection symptoms, such as:
- Headache
- Confusion
- Coordination problems
- Seizures
- Lung disorders that mirror tuberculosis or Pneumocystis jiroveci pneumonia, a common opportunistic infection in AIDS patients
- Blurred vision induced by acute retinal inflammation (ocular toxoplasmosis)
In infants
If you get sick for the first time just before or during your pregnancy, you can carry the infection to your kid (congenital toxoplasmosis), even if you don't have any symptoms.
If you become infected during the third trimester, your baby is most at risk of contracting toxoplasmosis, and your baby is least at risk if you become infected during the first trimester. On the other side, the sooner the illness arises in your pregnancy, the more devastating the outcome for your kid.
Many early infections result in miscarriage or stillbirth. Infants who survive are more likely to have major difficulties, such as:
- Seizures
- Liver and spleen enlargement
- Yellowing of the skin and eye whites (jaundice)
- Eye infections that are severe
Only a small percentage of newborns with toxoplasmosis develop symptoms at birth. Infected newborns frequently do not show symptoms until their teens or later, which might include hearing loss, mental incapacity, or significant eye infections.
WHAT ARE THE CAUSES OF TOXOPLASMOSIS?
Toxoplasma gondii (T. gondii) is a parasitic single-celled organism that may infect nearly all animals and birds. T. gondii infectious organisms are only shed in cat feces, so wild and domestic cats are the parasite's final host.
Although toxoplasmosis cannot be "caught" from an infected kid or adult, you can become infected if you:
- Come into contact with parasite-containing cat feces: If you touch your mouth after gardening, cleaning a litter box, or touching anything that has come into contact with infected cat feces, you may accidently eat the parasites. T. gondii is most likely to be found in cats that hunt or are fed raw meat.
- Consume polluted food or water: T. gondii is more likely to be found in lamb, pig, and venison. Unpasteurized dairy products may also contain the parasite. T. gondii-contaminated water is uncommon in the United States.
- Use contaminated knives, chopping boards, or other utensils: Unless thoroughly cleansed in hot, soapy water, kitchen items that come into touch with raw meat might carry parasites.
- Consume raw fruits and vegetables: The parasite may be present on the surface of fruits and vegetables. To be safe, properly wash and peel all produce, especially any that will be consumed raw.
- Receive an infected organ transplant or blood transfusion: Toxoplasmosis can be spread through an organ transplant or blood transfusion in rare situations.
When a person is infected with T. gondii, the parasite creates cysts that can harm practically any area of the body, most notably the brain and muscle tissue of various organs, including the heart.
If you're in good health, your immune system will keep the parasites at bay. They remain dormant in your body, providing you with lifelong protection and preventing you from becoming infected with the parasite again. However, if your immune system is weakened due to illness or treatment, the infection can resurface, resulting in significant problems.
WHAT ARE THE RISK FACTORS FOR TOXOPLASMOSIS?
Toxoplasmosis can infect anyone at any time. The parasite can be found all around the world.
Toxoplasmosis infection can cause major health problems if:
- You are infected with HIV/AIDS: Many persons with HIV/AIDS have toxoplasmosis, either as a new infection or a reactivated infection.
- You're having chemotherapy: Chemotherapy weakens your immune system, making even small illnesses difficult to fight.
- You use steroids or other immunosuppressive medications: Medications used to treat certain nonmalignant illnesses impair your immune system, increasing your risk of developing toxoplasmosis problems.
WHAT ARE THE COMPLICATIONS OF TOXOPLASMOSIS?
If you have a healthy immune system, you are unlikely to acquire toxoplasmosis problems, yet otherwise healthy people can develop eye infections. These infections, if left untreated, can cause blindness.
Toxoplasmosis, on the other hand, can cause convulsions and life-threatening infections such as encephalitis – a deadly brain infection if your immune system is impaired, especially if you have HIV/AIDS.
Untreated toxoplasmosis encephalitis is lethal in patients with AIDS. People with toxoplasmosis who also have a reduced immune system are always concerned about relapse.
Congenital toxoplasmosis in children can lead to debilitating problems such as hearing loss, mental impairment, and blindness.
HOW IS TOXOPLASMOSIS DIAGNOSED?
In the United States, most pregnant women are not routinely screened for toxoplasmosis, and most states do not screen infants for the illness. Toxoplasmosis is generally difficult to identify without specific screening since the signs and symptoms, when they appear, are similar to those of more prevalent disorders such as the flu and mononucleosis.
Testing when pregnant
If your doctor suspects you have the infection, blood tests to look for antibodies to the parasite may be ordered. Antibodies are proteins that your immune system produces in reaction to the presence of foreign things like parasites. Because these antibody tests might be difficult to interpret, the Centers for Disease Control and Prevention recommends that any positive results be validated by a toxoplasmosis-specific laboratory.
What do the test results mean?
You may be tested early in the disease's progression before your body has had a chance to generate antibodies. Even if you are infected, you may have a negative outcome in this scenario. To be sure, your doctor may advise you to retest several weeks later.
A negative toxoplasmosis test result usually suggests you've never been infected and hence aren't immune to the disease. If you are at high risk, you can take actions to avoid becoming sick.
A positive test could indicate that you have an active illness, or that you were previously afflicted and are now immune to the disease. Additional tests, based on the types of antibodies in your blood, can determine when the infection happened. This is especially critical if you are pregnant or have HIV/AIDS.
Testing your baby
If you are pregnant and have a current toxoplasmosis infection, the next step is to see if your baby is affected as well. Your doctor may order the following tests:
Amniocentesis: Your doctor will use a fine needle to remove a small amount of fluid from the fluid-filled sac that surrounds the fetus in this surgery, which can be done safely after 15 weeks of pregnancy (amniotic sac). The fluid is then tested to see if there is any sign of toxoplasmosis. Amniocentesis has a low risk of miscarriage and minor consequences including cramps, leaking fluid, or irritation where the needle was put.
Ultrasound scan: This test generates photos of your baby in the womb using sound waves. Toxoplasmosis cannot be diagnosed using a thorough ultrasound. However, it can reveal whether your baby has certain symptoms, such as fluid buildup in the brain (hydrocephalus). A negative ultrasound does not, however, rule out the chance of infection. As a result, your infant will require an examination as well as follow-up blood testing during the first year of life.
Testing in extreme situations
If you have a potentially fatal illness, such as encephalitis, you may require one or more imaging tests to look for lesions or cysts in your brain. These are some examples:
Magnetic resonance imaging (MRI): This test creates cross-sectional images of your skull and brain using a magnetic field and radio (electromagnetic) waves. You lie within a big, doughnut-shaped equipment that has a magnet surrounded by coils that send and receive radio waves during the treatment.
Your body creates small signals in reaction to the radio waves, which are picked up by the coils and processed into images by a computer. MRI is non-invasive and poses little health hazards.
Brain biopsy: A neurosurgeon may harvest a small sample of brain tissue in rare situations, especially if you do not react to treatment. The sample is subsequently tested for toxoplasmosis cysts in a laboratory.
WHAT ARE THE TREATMENTS FOR TOXOPLASMOSIS?
Toxoplasmosis treatment is not required in the majority of healthy people. However, if you are otherwise healthy and have acute toxoplasmosis symptoms, your doctor may prescribe the following drugs:
- Pyrimethamine (Daraprim): This folic acid antagonist is commonly used to treat malaria. It may inhibit your body from absorbing the B vitamin folate (folic acid, vitamin B-9), especially if used in large amounts over an extended length of time. As a result, your doctor may advise you to take more folic acid.
Other potential pyrimethamine adverse effects include bone marrow suppression and liver damage.
- Sulfadiazine: To treat toxoplasmosis, this antibiotic is used with pyrimethamine.
Treatment of HIV/AIDS patients
If you have HIV/AIDS, the best treatment for toxoplasmosis is pyrimethamine and sulfadiazine, along with folinic acid (leucovorin). Pyrimethamine in combination with clindamycin is an option (Cleocin).
Treating pregnant women and babies
If you are pregnant and have toxoplasmosis, your treatment may differ depending on where you seek medical attention.
You may be given the antibiotic spiramycin if the infection occurs before the 16th week of pregnancy. This medication may lessen your baby's chance of neurological disorders caused by congenital toxoplasmosis. Spiramycin is widely used in Europe to treat toxoplasmosis, but it is still considered experimental in the United States.
If you were infected after the 16th week of pregnancy, or if tests revealed that your unborn child had toxoplasmosis, you may be given pyrimethamine, sulfadiazine, and folinic acid (leucovorin). Your doctor will advise you on the best course of action.
If your infant has toxoplasmosis or is at risk of developing it, treatment with pyrimethamine, sulfadiazine, and folinic acid (leucovorin) is advised. Your baby's doctor will need to watch him or her while taking these medications.