Acute toxoplasmosis mimicking metastatic lymphadenopathy of sarcoma

Introduction: Parasitic myositis is caused by some parasites such as T. gondii and T. canis. So, the aim of the study was to evaluate the prevalence T. gondii and T. canis in patients with myositis and healthy individuals. Methods: A total of 108 samples were randomly selected as the control (54 healthy individuals) and test (54 myositis patients) groups. IgG and IgM antibodies against T. gondii and IgG antibodies against T. canis were measured by the ELISA. The detection of chronic and acute toxoplasmosis was performed by the ELISA IgG avidity. The presence of T. gondii in blood was evaluated by the nested-PCR. Results: Of 108, 33 (30.6%) cases were detected positive for IgG against T. gondii that 19 (35.2%) and 14 (25.9%) were observed in myositis patients and healthy individuals, respectively (P=0.296). Of 19 positive cases, 12 (63.2%) and 7 (36.8%) cases were detected as chronic and acute toxoplasmosis, respectively, while, all positive cases in the control group had chronic toxoplasmosis (P=0.013). One (1.9%) sample was detected positive for anti- Toxoplasma gondii IgM and two (3.7%) samples were found positive for IgG against T. canis by the ELISA that these positive cases were observed only in myositis patients (P=1.000 P=0.495, respectively). B1 T. gondii gene was amplified in 12 (63.2%) and 1 (7.1%) in myositis patients and healthy subjects (P=0.001). Conclusions: Our findings showed that there was a relatively high prevalence of acute toxoplasmosis in myositis patients in comparison with the control subjects in southwest of Iran.

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Genetic polymorphism for IFNγ +874T/A in patients with acute toxoplasmosis

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822012000600020 ◽

2012 ◽

Vol 45 (6) ◽

pp. 757-760 ◽

Cited By ~ 11

Author(s):

Elizabeth de Souza Neves ◽

André Luis Land Curi ◽

Maira Cavalcanti de Albuquerque ◽

Cassius Schnel Palhano-Silva ◽

Laura Berriel da Silva ◽

...

Keyword(s):

Single Nucleotide Polymorphism ◽

Case Control Study ◽

Severe Disease ◽

Clinical Manifestations ◽

Nucleotide Polymorphism ◽

Gene Encoding ◽

Single Nucleotide ◽

Duration Of Disease ◽

Acute Toxoplasmosis ◽

Control Study

INTRODUCTION: A single nucleotide polymorphism (SNP) in the gene encoding gamma interferon influences its production and is associated with severity of infectious diseases. This study aimed to evaluate the association of IFNγ+874T/A SNP with duration of disease, morbidity, and development of retinochoroiditis in acute toxoplasmosis. METHODS: A case-control study was conducted among 30 patients and 90 controls. RESULTS: Although statistical associations were not confirmed, A-allele was more common among retinochoroiditis cases and prolonged illness, while T-allele was more frequent in severe disease. CONCLUSIONS: Despite few cases, the results could indicate a relation between IFNγ+874T/A single nucleotide polymorphism and clinical manifestations of toxoplasmosis.

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Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmaa069 ◽

2020 ◽

Author(s):

Raquel Aitken Soares Mueller ◽

Ana Cristina Cisne Frota ◽

Daniela Durão Menna Barreto ◽

Daniela Pires Ferreira Vivacqua ◽

Gabriela Bueno Loria ◽

...

Keyword(s):

Antenatal Care ◽

Congenital Toxoplasmosis ◽

First Trimester ◽

University Hospital ◽

Serological Testing ◽

Missed Opportunities ◽

Clinic Appointment ◽

History Of ◽

Acute Toxoplasmosis ◽

Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

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P54 Development of ocular toxoplasmosis and panuveitis in a patient receiving infliximab for psoriatic arthritis

Rheumatology ◽

10.1093/rheumatology/keaa111.053 ◽

2020 ◽

Vol 59 (Supplement_2) ◽

Cited By ~ 1

Author(s):

Mariam Malik ◽

Himashi Anver ◽

Ernest Wong

Keyword(s):

Psoriatic Arthritis ◽

Past History ◽

Acute Infection ◽

Immunosuppressive Treatment ◽

Ocular Toxoplasmosis ◽

Close Monitoring ◽

Horse Riding ◽

Increased Risk ◽

History Of ◽

Acute Toxoplasmosis

Abstract Background Toxoplasma gondii is thought to infect up to a third of world’s population. Incidence rate of 0.4/100,000 has been calculated in Britain, culminating in a life-time risk of 18/100,000. Cats are primary hosts, but humans and warm-blooded animals can be infected by consumption of contaminated food/water. Although in most patients, it’s self-limiting, it can be devastating in immunosuppressed patients and may cause eye manifestations, cerebral abscesses or disseminated infection. Immunosuppressive therapies including treatment with biologics increases the risk and may also cause toxoplasmosis reactivation. Methods This is case of 57 year old lady with psoriatic arthritis. She has past history of congenital vision impairment in the left eye and is HLA B27 negative. She enjoyed horse-riding and had a pet dog. Initially she was started on methotrexate. Sulfasalazine was added later. Due to ongoing active disease, etanercept was used for 6 months, before being switched to cetrolizumab due to ineffectiveness. She had this for 5 months and then switched to infliximab, 3mg/kg, 8 weekly. In May 2019, she was seen by Ophthalmology for 2 weeks history of blurred vision and floaters in right eye. She was diagnosed to have panuveitis and had positive IgM for toxoplasma. Bloods revealed negative TB screen, HIV, Hep B&C, syphilis, lyme and anti-streptolysin antibody tests were negative. Infliximab levels were sub-therapeutic. She was commenced on 30mg prednisolone for possible inflammatory process secondary to seronegative arthropathy, but acute toxoplasmosis could not be excluded. Hence, she was started on azithromycin and had vitreous biopsy. Toxoplasma was detected in the sample, confirming acute infection. Methotrexate and infliximab were stopped. MRI head ruled out intracranial involvement. Following treatment of acute toxoplasmosis, adalimumab is now being considered for management of her inflammatory disease, with close monitoring by local infectious-disease team and specialist ophthalmology unit. Results This lady developed ocular toxoplasmosis and panuveitis, whilst on immunosuppression for psoriatic arthritis. She was a horse-rider and had exposure to dogs. Diagnosing toxoplasma in immunocompromised can be difficult. Isolation of T. gondii in tissue usually confirms diagnosis. Some forms of immunosuppressive treatment may be associated with increased risk of reactivation of toxoplasmosis but there is not much evidence to assess the relative risk of various therapies. Conclusion Ocular toxoplasmosis needs to be considered in patients receiving immunosupression and presenting with inflammatory eye symptoms. Management requires specialist input and close monitoring. Further research into diagnostic techniques, possibility of using prophylaxis in high-risk patients and management guidelines would be helpful. Disclosures M. Malik None. H. Anver None. E. Wong None.

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Pregnancy as a risk factor for acute toxoplasmosis seroconversion

European Journal of Obstetrics & Gynecology and Reproductive Biology ◽

10.1016/s0301-2115(02)00353-6 ◽

2003 ◽

Vol 108 (1) ◽

pp. 19-24 ◽

Cited By ~ 40

Author(s):

Mariza Martins Avelino ◽

Dioclécio Campos ◽

Josetti do Carmo Barbosa de Parada ◽

Ana Maria de Castro

Keyword(s):

Risk Factor ◽

Acute Toxoplasmosis

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Cervical Cat Scratch Disease Lymphadenitis in a Patient with Immunoglobulin M Antibodies to Toxoplasma gondii

Clinical and Vaccine Immunology ◽

10.1128/cdli.9.2.496-498.2002 ◽

2002 ◽

Vol 9 (2) ◽

pp. 496-498

Author(s):

Mardjan Arvand ◽

Ilkay Kazak ◽

Sergije Jovanovic ◽

Hans-Dieter Foss ◽

Oliver Liesenfeld

Keyword(s):

Toxoplasma Gondii ◽

Clinical Symptoms ◽

Bartonella Henselae ◽

Cervical Lymphadenopathy ◽

Immunoglobulin M ◽

Cat Scratch Disease ◽

Specific Immunoglobulin ◽

Acute Toxoplasmosis

ABSTRACT We report on a young patient with chronic cervical lymphadenopathy and serological and histological evidence for infection with Bartonella henselae and Toxoplasma gondii. Serological follow-up studies, including testing for avidity of Toxoplasma-specific immunoglobulin G antibodies, assisted in the determination of the cause of the acute lymphadenitis. Our results suggest that the clinical symptoms were most likely due to cat scratch disease rather than to acute toxoplasmosis.

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Lectins for the detection of IgM antibodies to T. gondii in the diagnosis of acute toxoplasmosis by immunofluorescence test

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651987000600004 ◽

1987 ◽

Vol 29 (6) ◽

pp. 354-360

Author(s):

I. T. I. Nojimoto ◽

S. Hoshino-Shimizu ◽

T. K. Nagasse-Sugahara ◽

M. E. Camargo

Keyword(s):

Relative Efficiency ◽

Healthy Subjects ◽

Lens Culinaris ◽

Test Results ◽

Immunofluorescence Test ◽

Igm Antibodies ◽

Acute Toxoplasmosis

Lectins were labeled with fluorescein and tried as conjugates in the immunofluorescence (IP) test for the detection of IgM antibodies to T. gondii, in the diagnosis of acute toxoplasmosis. This approach was an attempt to find alternative reagents for anti-human IgM fluorescent conjugates (AHIgMFC), which contain quite frequently anaibcdies to toxoplasma, as contaminants, due to natural T. gondii infections among animals used for imunization. Lentil (Lens culinaris) lectin fluorescence conjugates (LcFC) provided most satisfactory results. The evaluation of LcFC carried out in a total of 179 sera from patients with acute and chronic toxoplasmosis, with non-related infections or healthy subjects, gave high values of relative efficiency, co-positivity and co-negativity indices, respectively 0.989, 0.969 and 1.000, in reference to the conventional AHIgMFC. Moreover, three batches of LcFC successively prepared gave reproducible test results. The advantage of LcFC as an alternative reagent for the serodiagnosis of acute toxoplasmosis is supported by practical aspects of its preparation.

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Toxoplasmosis serology: an efficient hemagglutination procedure to detect IgG and IgM antibodies

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46651989000400012 ◽

1989 ◽

Vol 31 (4) ◽

pp. 279-285 ◽

Cited By ~ 6

Author(s):

M.E. Camargo ◽

Maria Emilia G. Moura ◽

P.G. Leser

Keyword(s):

Simple Procedure ◽

Low Cost ◽

Protein A ◽

Developed Countries ◽

Serum Samples ◽

Serum Dilution ◽

Specific Antibodies ◽

Igm Antibodies ◽

Diagnostic Capability ◽

Acute Toxoplasmosis

In search of an efficient but simple, low cost procedure for the serodiagnosis of Toxoplasmosis, especially suited for routine laboratories facing technical and budget limitations as in less developed countries, the diagnostic capability of Hematoxo® , an hemagglutination test for toxoplasmosis, was evaluated in relation to a battery of tests including IgG- and IgM-immunofluorescence tests, hemagglutination and an IgM-capture enzymatic assay. Detecting a little as 5 I.U. of IgG antitoxoplasma antibodies, Hematoxo® showed a straight agreement as to reactivity and non-reactivity for the 443 non-reactive and the 387 reactive serum samples, included in this study. In 23 cases presenting a serological pattern of acute toxoplasmosis and showing IgM antibodies, Hematoxo® could detect IgM antibodies in 18, indicated by negativation or a significant decrease in titers as a result of treating samples with 2-mercapto-ethanol. However, a neat increase in sensitivity for IgM specific antibodies could be achieved by previously removing IgG from the sample, as demonstrated in a series of acute toxoplasmosis sera. A simple procedure was developed for this purpose, by reconstituting a lyophilized suspension of Protein A - rich Staphylococcus with the lowest serum dilution to be tested. Of low cost and easy to perform, Hematoxo® affords not only a practical qualitative procedure for screening reactors and non-reactors, as in prenatal services, but also quantitative assays that permit to titrate antibodies as well as to identify IgM antibodies.

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Acute Toxoplasma Dissemination With Encephalitis in the Era of Biological Therapies

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy259 ◽

2018 ◽

Vol 5 (11) ◽

Cited By ~ 3

Author(s):

Amal A Gharamti ◽

Amy Rao ◽

Paula E Pecen ◽

Andrés F Henao-Martínez ◽

Carlos Franco-Paredes ◽

...

Keyword(s):

Severe Disease ◽

Biological Response ◽

Laboratory Diagnosis ◽

Clinical Findings ◽

Organ Involvement ◽

Biological Response Modifiers ◽

Biological Therapies ◽

Acute Toxoplasmosis

Abstract We report the case of a 65-year-old patient with pseudolymphoma who developed acute toxoplasmosis following 6 cycles of rituximab and bendamustine therapy. Acute toxoplasmosis in the setting of biological response modifiers, rather than reactivation, is a unique unreported infection. The patient developed severe disease with multi-organ involvement, including retinitis, myocarditis, and myositis. We discuss the clinical findings, epidemiology, and laboratory diagnosis.

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