About toxoplasmosis

What is toxoplasmosis?

Toxoplasmosis is an infection caused by a single-celled parasite called Toxoplasma gondii. The infection is most commonly acquired from contact with cats and their feces or with raw or undercooked meat.

The U.S. Centers for Disease Control and Prevention (CDC) estimates that more than 60 million people in the United States may carry the Toxoplasma parasite, but very few have symptoms because a healthy immune system usually keeps the parasite from causing illness.

What are the symptoms for toxoplasmosis?

Most healthy people who are infected with toxoplasmosis have no signs or symptoms and aren't aware that they're infected. Some people, however, develop signs and symptoms similar to those of the flu, including:

In people with weakened immune systems

If you have HIV/AIDS, are receiving chemotherapy or have recently had an organ transplant, a previous toxoplasma infection may reactivate. In that case, you may develop more-severe signs and symptoms of infection, including:

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

In babies

If you become infected for the first time just before or during your pregnancy, you can pass the infection to your baby (congenital toxoplasmosis), even if you don't have signs and symptoms yourself.

Your baby is most at risk of contracting toxoplasmosis if you become infected in the third trimester and least at risk if you become infected during the first trimester. On the other hand, the earlier in your pregnancy the infection occurs, the more serious the outcome for your baby.

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

  • Seizures
  • An enlarged liver and spleen
  • Yellowing of the skin and whites of the eyes (jaundice)
  • Severe eye infections

Only a small number of babies who have toxoplasmosis show signs of the disease at birth. Often, infants who are infected don't develop signs — which may include hearing loss, mental disability or serious eye infections — until their teens or later.

When to see a doctor

If you are living with HIV or AIDS or are pregnant or thinking of becoming pregnant, talk to your doctor about being tested if you think you may have been exposed to toxoplasmosis.

The signs and symptoms of severe toxoplasmosis — blurred vision, Confusion, loss of coordination — require immediate medical care, particularly if your immune system has been weakened.

What are the causes for toxoplasmosis?

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 domestic cats are the parasite's ultimate host.

Although you can't "catch" toxoplasmosis from an infected child or adult, you can become infected if you:

  • Come into contact with cat feces that contain the parasite. You may accidentally ingest the parasites if you touch your mouth after gardening, cleaning a litter box or touching anything that has come in contact with infected cat feces. Cats who hunt or who are fed raw meat are most likely to harbor T. gondii.
  • Eat or drink contaminated food or water. Lamb, pork and venison are especially likely to be infected with T. gondii. Occasionally, unpasteurized dairy products also may contain the parasite. Water contaminated with T. gondii isn't common in the United States.
  • Use contaminated knives, cutting boards or other utensils. Kitchen utensils that come into contact with raw meat can harbor the parasites unless the utensils are washed thoroughly in hot, soapy water.
  • Eat unwashed fruits and vegetables. The surface of fruits and vegetables may contain the parasite. To be safe, thoroughly wash and peel all produce, especially any you eat raw.
  • Receive an infected organ transplant or transfused blood. In rare cases, toxoplasmosis can be transmitted through an organ transplant or blood transfusion.

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

If you're generally healthy, your immune system keeps the parasites in check. They remain in your body in an inactive state, providing you with lifelong immunity so that you can't become infected with the parasite again. But if your immune system is weakened by disease or certain medications, the infection can be reactivated, leading to serious complications.

What are the treatments for toxoplasmosis?

Once the diagnosis of toxoplasmosis is confirmed, you and your doctor should discuss whether treatment is necessary. In an otherwise healthy person who is not pregnant, treatment is not needed. Symptoms will usually go away within a few weeks. For pregnant women or people who have weakened immune systems, drugs are available to treat the parasite that causes toxoplasmosis.

What are the risk factors for toxoplasmosis?

Anyone can become infected with toxoplasmosis. The parasite is found throughout 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 a recent infection or an old infection that has reactivated.
  • You're undergoing chemotherapy. Chemotherapy affects your immune system, making it difficult for your body to fight even minor infections.
  • You take steroids or other immunosuppressant drugs. Medications used to treat certain nonmalignant conditions suppress your immune system and make you more likely to develop complications of toxoplasmosis.

Is there a cure/medications for toxoplasmosis?

Mostly, healthy people need not undergo toxoplasmosis treatment. If you have signs and symptoms of acute toxoplasmosis, the following drugs may be prescribed:

  • Pyrimethamine (Daraprim): A folic acid antagonist that may prevent your body from absorbing the B vitamin folate (folic acid, vitamin B-9). Hence, your doctor may recommend taking additional folic acid.
  • Sulfadiazine: This antibiotic is used along with pyrimethamine to treat toxoplasmosis.
  • In case of people with HIV/AIDS: The treatment of choice for people with HIV/AIDS is also pyrimethamine and sulfadiazine, with folinic acid (leucovorin). Pyrimethamine along with clindamycin (Cleocin) may also be prescribed.
  • In the case of pregnant women: Treatment may vary for pregnant women depending on where you receive medical care. If infection occurs before the 16th week of pregnancy, antibiotic spiramycin may be prescribed. If the infection occurs after the 16th week of pregnancy, you'll be given pyrimethamine and sulfadiazine and folinic acid (leucovorin).
  • Infants: If your infant has toxoplasmosis, treatment with pyrimethamine and sulfadiazine and folinic acid (leucovorin) is recommended.
  • Preventive measures: Wearing gloves when handling soil, garden works, work outdoors can help. Wash your hands thoroughly with soap and water afterward.

Blurred vision,Confusion,Loss of coordination
Pyrimethamine (Daraprim),Sulfadiazine,Antibiotic spiramycin (for pregnant women),Pyrimethamine and sulfadiazine, with folinic acid (leucovorin) for HIV patients
Swollen lymph glands, especially around the neck,Muscle aches and pains,Headache,Fever,Generally feeling unwell,Inflammation of the lungs,Inflammation of the heart muscle,Inflammation of the eye, for example, the retina (at the back of the eye)

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