Toxoplasmosis

Toxoplasmosis is the symptomatic disease caused by the ubiquitous protozoan parasite Toxoplasma gondii. T. gondii is a common parasitic infection that causes a long-term, generally asymptomatic infection that can reactivate in the immunocompromised. The major organs in which T. gondii persists are the skeletal and cardiac muscle and the central nervous system (especially the brain and retina). In immunocompetent individuals, acute T. gondii infection can cause lymphadenitis, chorioretinitis, and rarely more severe infections. Congenital infection and infection in immunocompromised patients can lead to life-threatening disease, most commonly with brain manifestations. Universal screening is recommended in all pregnant women. A positive polymerase chain reaction test or detection of toxoplasma tachyzoites in any bodily fluid is diagnostic. Common treatment regimens are trimethoprim-sulfamethoxazole, pyrimethamine (plus folinic acid) plus sulfadiazine, clindamycin, or atovaquone. With early treatment, outcomes are generally good, but congenital infection is associated with a high rate of miscarriage and severe malformations.