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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Toxoplasmosis

Last reviewed: December 1, 2009.

Toxoplasmosis is an infection due to the parasite Toxoplasma gondii.

Causes, incidence, and risk factors

Toxoplasmosis is found in humans worldwide, and in many species of animals and birds. Cats are the definitive host of the parasite.

Human infection may result from:

  • Blood transfusions or solid organ transplants

  • Carelessly handling cat litter, which can lead to accidental consumption of infectious particles

  • Eating contaminated soil

  • Eating raw or undercooked meat (lamb, pork, and beef)

Toxoplasmosis also affects people who have weakened immune systems.

The infection may also be passed from an infected mother to her baby through the placenta. See: Congenital toxoplasmosis

Symptoms

Most primary infections produce no symptoms. The time between exposure to the parasite and symptom development is 1 - 2 weeks. The disease can affect the brain, lung, heart, eyes, or liver.

Symptoms in persons with otherwise healthy immune systems:

Symptoms in immunosuppressed persons:

For symptoms in babies born with the condition, see congenital toxoplasmosis.

Signs and tests

Tests to determine infection or to find cysts related to this infection:

Treatment

Those without symptoms typically do not need treatment.

Medications to treat the infection include an antimalarial drug and antibiotics. AIDS patients should continue treatment for as long as their immune system is weak to prevent the disease from reactivating.

For information regarding treatment of babies and pregnant women, see congenital toxoplasmosis.

Expectations (prognosis)

Acute infection in children may cause swelling of the retina in the eye.

In adults with a healthy immune system, toxoplasmosis has a good outcome.

Complications

  • Permanent disability, such as blindness or learning disorders, in infants with congenital toxoplasmosis

  • Return of the disease

  • Spread of infection in a person with a weakened immune system (can be deadly)

Calling your health care provider

Call for an appointment with your health care provider if you develop symptoms of toxoplasmosis. This disorder requires urgent or emergency care if it occurs in an immunosuppressed person or in a baby, or if confusion, seizures, or other severe symptoms develop.

Prevention

Tips for preventing this condition:

  • Avoid undercooked meats.

  • Freeze meat to minus 20 degrees Celsius for 2 days.

  • Wash hands after handling raw meat.

  • Protect children's play areas from cat and dog feces.

  • Wash your hands thoroughly after contact with soil that may be contaminated with animal feces.

  • Pregnant women and those with weakened immune systems should avoid cleaning cat litter boxes and materials that are potentially infected with cat feces. They should also avoid materials that could be contaminated by insects exposed to cat feces (cockroaches, flies, etc.).

  • Pregnant women should have a blood test for toxoplasmosis.

  • Patients with HIV disease should have blood tests to screen for toxoplasmosis.

References

  1. Liesenfeld O. Toxoplasmosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 370.

Review Date: 12/1/2009.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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What works?

  • Prenatal education for congenital toxoplasmosis Prenatal education for congenital toxoplasmosis
    Toxoplasmosis infection is caused by a parasite, Toxoplasma gondii. Eating raw or insufficiently cooked meat, not washing hands thoroughly after handling raw meat or gardening, or contact with cats' faeces (directly or indirectly through the soil, or possibly contaminated raw vegetables or fruits) can cause infection. Usually it is asymptomatic and self‐limited. If pregnant women have not previously been exposed to the parasite and developed antibodies (immunoglobulins) while pregnant, the infection can be transmitted from the mother to the fetus (congenital toxoplasmosis). This is rare but has potentially serious effects of malformation, mental retardation, deafness and blindness of the infected infant, intrauterine death or stillbirth. The probability of infection is greater during the third trimester but the risk of the fetus developing major clinical signs is greater earlier in pregnancy. Primary prevention or population surveillance involves educating the general public, filtering water, improving farm hygiene to reduce animal infection, and offering prenatal education to pregnant women or women of reproductive age so that they can avoid toxoplasmosis through adopting simple behavioral measures. Evidence supporting prenatal education to prevent congenital toxoplasmosis is limited. It does indicate that prenatal education can change pregnant women's behavior to avoid risk factors for toxoplasmosis infection during pregnancy. The one controlled trial identified by the review authors was from Canada and involved 432 women who were randomly assigned to a 10 minute presentation about toxoplasmosis prevention that focused on cat, food and personal hygiene during their first prenatal class, or to their usual prenatal class.
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Figures

  • Slit-lamp exam.
    Congenital toxoplasmosis.
    Antibodies.

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