What is toxoplasmosis?

Overview
Toxoplasmosis (ok-so-plaza-plaz-sis) is an ailment that ends from infection with the Toxoplasma gondii parasite, one of the world’s most common parasites. Infection usually occurs by eating undercooked spoiled meat, exposure from infected cat feces, or mother-to-child transmission throughout pregnancy.

Toxoplasmosis may trigger flu-like symptoms in some people, but most people impacted never create signs and symptoms. For infants born to infected mothers and for individuals with impaired immune systems, toxoplasmosis may trigger severe complications.

If you’re ordinarily healthy, and you are not pregnant and have been diagnosed with toxoplasmosis, you presumably will not require any treatment other than conventional management. If you’re pregnant or have compromised immunity, you may need medical management to avoid severe complications. The best method, though, is prevention.

Symptoms
Most healthy people who are contaminated with toxoplasmosis have no signs or symptoms and don’t know that they’re infected. Some people, nevertheless, develop symptoms and signs similar to those of the flu, including:

  • Fever
  • A headache
  • Body aches
  • Swollen lymph nodes
  • Fatigue

In people with impaired immune systems
If you have HIV/AIDS, are receiving chemotherapy or have recently had an organ transplant, a former toxoplasma infection may recrudesce. In that case, you may incur more-severe signs and symptoms of infection, including:

  • Confusion
  • Seizures
  • A headache
  • Poor coordination
  • Lung problems that may resemble tuberculosis or Pneumocystis jiroveci pneumonia, a common opportunistic infection that transpires in people with AIDS
  • Blurred vision triggered by severe inflammation of your retina (ocular toxoplasmosis)

In infants:
If you develop an infection for the initial time just before or during your pregnancy, you can pass the contagion to your baby (congenital toxoplasmosis), even if you don’t have symptoms and indications yourself.

Your child is most at risk of incurring toxoplasmosis if you become affected in the third trimester and least at risk if you become infected through the first trimester. On the other hand, the earlier in your pregnancy the infection happens, the more pressing the outcome for your baby.

Unfortunately, many early infections end in miscarriage or stillbirth. Infants who survive are expected to be born with serious problems, such as:

  • Seizures
  • An enlarged liver and spleen
  • Severe eye infections
  • (Jaundice) Yellowing in the whites of the eyes as well as skin.

Only a small percentage of babies who have toxoplasmosis exhibit signs of the disease at birth. Often, infants who are infected don’t develop signs — which may involve mental illness, hearing loss, or serious eye infections — until their teenagers or later.

When to see a physician
If you are living with HIV or AIDS or are pregnant or are considering becoming pregnant, talk to your physician about being examined if you believe you may have been in contact with toxoplasmosis.

The symptoms and signs of severe toxoplasmosis — blurred vision, loss of coordination, confusion — necessitate prompt medical care, particularly if your immune system has been impaired.

Causes
Toxoplasma gondii (T. gondii) is a single-celled parasitic organism that can infect most animals and birds. Because T. gondii infectious organisms are excreted only in cat feces, wild and domesticated cats are the parasite’s terminal host.

Although you can’t “catch” toxoplasmosis from an infected child or adult, you can grow infected if you:

  • Come into touch with cat feces that carry the parasite. You may inadvertently ingest the parasites if you touch your mouth after gardening, raking a litter box or coming into contact with anything that has touched the infected cat feces. Cats who hunt or who are fed raw meat are most inclined to have T. gondii.Eat or drink contaminated food or water. Lamb, venison, and pork, a are particularly likely to be infected with T. gondii.
  • Occasionally, unpasteurized dairy products also may harbor the parasite. Water contaminated with T. gondii isn’t prevalent in the United States.
  • Use contaminated forks, spoons, knives, cutting boards or other appliances. Kitchen utensils that come into touch raw meat can harbor the parasites except the utensils are washed wholly in hot, soapy water.
  • Eat unclean or unwashed vegetables and fruits. The surface of fruits and vegetables may hold the parasite. To be secure, thoroughly wash and peel all produce, specifically any you eat raw.
  • Receive infected transfused blood or organ transplant. In rare cases, toxoplasmosis can be spread through an organ transplant or blood transfusion.

When a person becomes infected with T. gondii, the parasite forms cysts that can impact almost any area of the body — often your muscle and brain tissue of several organs, including the heart.

If you’re generally healthy, your immune system holds the parasites in check and blocks them from impacting the body. They reside in your body in a dormant state, equipping you with immunity throughout your life so that you can’t grow infected with the parasite again. However, if disease or particular medications impair your immune system, the infection can be revived, starting serious complications.

Risk factors
Anyone can become affected with toxoplasmosis. The parasite is located all around the world.

You’re at risk of serious health problems from toxoplasmosis infection if:

You have HIV/AIDS. Many people with HIV/AIDS also have toxoplasmosis, either recent infection or an old infection that has reactivated.
You’re experiencing chemotherapy. Chemotherapy alters your immune system, making it difficult for your body to fight even lesser infections.
You take steroids or other immunosuppressant drugs. Medications utilized to treat specific nonmalignant conditions restrain your immune system and make you more prone to produce complications of toxoplasmosis.

Complications
If you have a healthy immune system, you’re not anticipated to experience difficulties of toxoplasmosis, although otherwise healthy people seldom develop eye infections. Untreated, these infections can generate blindness.

But if your immune system is undermined, especially as a result of HIV/AIDS, toxoplasmosis can point to seizures and life-threatening diseases such as encephalitis — a severe brain infection.

In individuals with AIDS, untreated encephalitis from toxoplasmosis is fatal. Relapse is a consistent concern for people with toxoplasmosis who also have a debilitated immune system.

Children with congenital toxoplasmosis may form into disabling complications, encompassing hearing loss, blindness, and mental disability.

Prevention
Taking special regard can help prevent toxoplasmosis:

Wear gloves when you are gardening or handling soil. Wear gloves whenever you work outside and wash your hands fully with soap and water after you are done and especially before consuming anything.
Don’t eat raw or undercooked meat. Meat, specifically pork, lamb,, and beef, can have toxoplasma organisms. Avoid tasting meat before it’s fully cooked. Avoid raw cured meat.

Wash kitchen utensils completely. After cooking raw meat, wash cutting boards, knives, and other utensils in hot, soapy water to stop cross-contamination of other foods. Wash your hands following touching raw meat.
Wash all of your fruits and vegetables. Scrub fresh fruits and vegetables, particularly if you plan to eat them raw. Remove the skin peels when possible, but do so only after washing.
Avoid drinking unpasteurized milk. Unpasteurized milk and other dairy foods may contain toxoplasma parasites.
Cover children’s sandboxes. If you have a sandbox, close it when your children are not playing in it to keep cats from using it as a litter box.

Diagnosis
The majority pregnant women in the United States aren’t not normally screened for toxoplasmosis, and most states do not require screen infants for the infection. Without specific screening, toxoplasmosis is often challenging to diagnose since signs and symptoms, when they transpire, are similar to those of more typical illnesses, such as mononucleosis and the flu.

Testing during pregnancy
If your physician speculates you have the infection, you may request blood tests that monitor for antibodies to the parasite. Antibodies are proteins created by your immune system in response to the appearance of foreign substances, like parasites. Since antibody tests can be tough to interpret, the Centers for Disease Control and Prevention suggests that all positive results be verified by a laboratory that focuses on diagnosing toxoplasmosis.

What do these tests mean
Occasion you may be examined early in the course of the disease before your body has a chance to develop antibodies. In that case, you may have a adverse outcome, despite that fact you’re infected. To be positive, your physician may suggest retesting several weeks later.

In most situations, a negative toxoplasmosis test result indicates you’ve never been infected and consequently aren’t immune to the disease. If you’re at elevated risk, you can exercise certain precautions so that you don’t become infected.

A positive result could indicate that you have an active infection, or it could mean that you were once infected and are immune to the disease. Additional tests can isolate when the infection occurred, based on the types of antibodies in your blood. This is particularly imperative if you’re pregnant or you have HIV/AIDS.

Testing your baby
If you are pregnant and have an existing toxoplasmosis infection, the next step is to decide whether your baby also is affected. Tests your doctor may suggest include:

Amniocentesis. In this treatment, which may be done securely after 15 weeks of pregnancy, your surgeon uses a fine needle to extract a small volume of fluid from the fluid-filled sac that encloses the fetus (amniotic sac). Tests are then conducted on the fluid to check for proof of toxoplasmosis. Amniocentesis carries a slight risk of miscarriage and lesser complications, such as cramping, leaking fluid or irritation where the needle was inserted.

Ultrasound scan. This test employs sound waves to produce images of your baby in the womb. A comprehensive ultrasound can’t diagnose toxoplasmosis. It can, however, reveal whether your baby has certain signs, such as fluid accumulation in the brain (hydrocephalus). However, a negative ultrasound doesn’t rule out the chance of infection. For that purpose, your newborn will require an analysis and follow-up blood tests during the first year of life.

Testing in severe cases
If you’ve acquired a life-threatening illness such as encephalitis, you may require one or more imaging tests to monitor for lesions or cysts in your brain. These include:

Magnetic resonance imaging (MRI). This test leverages a magnetic field and radio (electromagnetic) waves to produce cross-sectional images of your brain and head. During the procedure, you lie within a large, doughnut-shaped machine that contains a magnet surrounded by coils that send and receive radio waves.

In reaction to the radio waves, your body generates faint signals that are pulled up by the coils and developed into images by a computer. MRI is noninvasive and poses minimum risks to your health.

Brain biopsy. In rare circumstances, particularly if you don’t respond to treatment, a neurosurgeon may collect a small sample of brain tissue. The specimen is then examined in a laboratory to review ed for toxoplasmosis cysts.

Treatment
Most healthy people don’t need toxoplasmosis treatment. But if you’re otherwise healthy and have signs and symptoms of acute toxoplasmosis, your physician may prescribe the following drugs:

Pyrimethamine (Daraprim). This medication, typically employed for malaria, is a folic acid antagonist. It may block your body from absorbing the B vitamin folate (folic acid, vitamin B-9), notably when you necessitate high doses over an extended period. For that reason, your physician may recommend taking additional folic acid.

Other potential side effects of pyrimethamine comprise of bone marrow suppression and liver toxicity.

Sulfadiazine. This antibiotic is used with pyrimethamine to treat toxoplasmosis.

Treating individuals with HIV/AIDS
If you have HIV/AIDS, the treatment preference for toxoplasmosis is also pyrimethamine and sulfadiazine, with folinic acid (leucovorin). An alternative is a pyrimethamine taken with clindamycin (Cleocin).

Attending pregnant women and babies
If you’re pregnant and infected with toxoplasmosis, treatment may alternate based on where you receive medical care.

If infection transpired before the 16th week of pregnancy, you might get prescribed the antibiotic spiramycin. Use of this medication may decrease your baby’s risk of neurological problems from congenital toxoplasmosis. Spiramycin is generally used to treat toxoplasmosis in Europe but is still deemed experimental in the United States.

If infection happened after the 16th week of pregnancy, or if tests show that your unborn child has toxoplasmosis, you may be provided sulfadiazine and pyrimethamine and folinic acid (leucovorin). Your physician will assist you to determine the optimal treatment.

If your newborn has toxoplasmosis or is likely to have it, treatment with sulfadiazine and pyrimethamine and folinic acid (leucovorin) is suggested. Your baby’s physician will need to monitor your baby while he or she is taking these medications.