Toxoplasmosis

• 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:

  • Enlarged lymph nodes in the head and neck
  • Headache
  • Mild illness with fever, similar to mononucleosis
  • Muscle pain
  • Sore throat

  Symptoms in immunosuppressed persons:

  • Confusion
  • Fever
  • Headache
  • Retinal inflammation that causes blurred vision
  • Seizures

  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:

  • Antibody titers for toxoplasmosis
  • Cranial CT scan
  • MRI of head
  • Slit lamp exam
  • Brain biopsy
• 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

  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.