Toxoplasmosis. Toxoplasma gondii tachyzoites (Giemsa stain).
Tssue cysts of T gondii.
Toxoplasma gondii tachyzoites in cell line.
Mama poate fi asimptomatică. Infectarea precoce, în jurul a 2-3 luni de sarcină, practic când are loc organogeneza, este foarte gravă, putând apărea avort spontan, moartea fătului la naştere sau leziuni importante neurologice şi oftalmologice, hidrocefalie sau microcefalie, calcificări intracraniene şi corioretinita cronică.
Dacă infecţia cu Toxoplasma se produce în cel de-al treilea trimestru de sarcină, copilul se poate naşte viu, dar poate manifesta icter, hepatosplenomegalie, retard psihomotor sau manifestări oculare (strabism, orbire, cataractă) şi hepatice.
The classic clinical triad of retinochoroiditis, cerebral calcifications, and convulsions defines congenital toxoplasmosis. Other findings include the following:
- Psychomotor retardation
Girl with hydrocephalus due to congenital toxoplasmosis
Intracranial calcifications in congenital toxoplasmosis. (A) Posterior-anterior and (B) lateral views of the skull showing scattered bilateral calcific flecks, nodules and linear streaks in frontal and parietal lobes of an infected infant.
Congenital toxoplasmosis with intracranial hyrocephalus. The grossly dilated lateral ventricles are outlined with air on (A) AP and (B) lateral radiographs after pneumoencephalography. There is spreading of the cranial sutures due to increased intracranial pressure.
Acute toxoplasmosis in immunocompetent persons
Approximately 80-90% of patients are asymptomatic. Symptomatic disease may be characterized as follows:
Patients may have cervical lymphadenopathy with discrete, usually nontender, nodes smaller than 3cm in diameter
Fever, malaise, night sweats, and myalgias have been reported
Patients may have a sore throat
Retroperitoneal and mesenteric lymphadenopathy with abdominal pain may occur
Retinochoroiditis is reported
Acute toxoplasmosis in hosts who do not have AIDS but are immunodeficient
The disease in these patients may be newly acquired or a reactivation. It may be characterized as follows:
CNS toxoplasmosis occurs in 50% of patients - Seizure, dysequilibrium, cranial nerve deficits, altered mental status, focal neurologic deficits, headache
Patients may have encephalitis, meningoencephalitis, or mass lesions
Hemiparesis and seizures have been reported
Patients may report visual changes
They may have signs and symptoms similar to those observed in immunocompetent hosts.
Patients may have flulike symptoms and lymphadenopathy
Myocarditis and pneumonitis are reported.
Toxoplasmic pneumonitis can occur - Typical symptoms of a pulmonary infection, mirroring in particular P (carinii) jiroveci, including nonproductive cough, dyspnea, chest discomfort, and fever
Clinical manifestations of toxoplasmosis in patients with AIDS
Brain involvement (ie, toxoplasmic encephalitis), with or without focal CNS lesions, is the most common manifestation of toxoplasmosis in individuals with AIDS.
Clinical findings include the following:
- Altered mental state
- Cranial nerve disturbances
- Sensory abnormalities
- Cerebellar signs
- Movement disorders
- Neuropsychiatric manifestations
The characteristic presentation is usually a subacute onset, with focal neurologic abnormalities in 58-89% of cases. However, in 15-25% of cases, the clinical presentation is more abrupt, with seizures or cerebral hemorrhage.
Toxoplasma gondii Infections (Toxoplasmosis). Infant girl with congenital toxoplasmosis with hepatosplenomegaly.
Papillitis secondary to toxoplasmosis, necessitating immediate systemic therapy.
Perimacular scars secondary to toxoplasmosis
Peripapillary scars secondary to toxoplasmosis
Inactive retinochoroidal scar secondary to toxoplasmosis
Ring enhancing mass with extensive perilesional edema in the left parietal region , with mass effect. A case of toxoplasmosis.
Bilateral basal ganglia toxoplasmosis
MULTIPLE TOXOPLASMOSIS- image shows an extensive area of vasogenic edema in the left pariteal cortex. Contrast enhanced scans show multiple ring enhancing toxoplasma.
Ventriculitis and hydrocephalus: an unusual presentation of toxoplasmosis in an adult with human immunodeficiency virus
Spiramicina, Clindamicina, Azitomicina, Claritromicina