Ocular Involvement Following Postnatally Acquired Toxoplasma gondii Infection in Southern Brazil: A 28-Year Experience

Arantes, Tiago Eugênio Faria e; Silveira, Cássio; Holland, Gary N.; Muccioli, Cristina; Yu, Fei; Jones, Jeffrey L.; Goldhardt, Raquel; Lewis, Kevan G.; Belfort, Rubens

doi:10.1016/j.ajo.2015.02.015

Cited by 47 publications

(36 citation statements)

References 40 publications

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“…Uncontrolled tachyzoite replication causes severe and potentially life-threatening disease to: i) fetuses whose mothers were infected for the first time during pregnancy, ii) immune-compromised individuals after a tissue cyst reactivates, and iii) otherwise healthy individuals who are susceptible to developing severe disease and particularly, ocular toxoplasmosis, when infected by specific Toxoplasma strains that are endemic to South America [4–7]. In each case, clinical severity is due to a combination of parasite growth, tissue damage, and inflammatory responses.…”

Section: Toxoplasma Growth and Development Within Tissuesmentioning

confidence: 99%

Brains and Brawn: Toxoplasma Infections of the Central Nervous System and Skeletal Muscle

Wohlfert

Blader

Wilson

2017

Trends in Parasitology

116

111

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Toxoplasma gondii is a widespread parasitic pathogen that infects over a third of the world’s population. Following an acute infection, the parasite can persist within its mammalian host as intraneuronal or intramuscular cysts. Cysts will occasionally reactivate, and depending on the host’s immune status and site of reactivation, encephalitis or myositis can develop. Because these diseases have high levels of morbidity and can be lethal, it is important to understand how Toxoplasma traffics to these tissues, how the immune response controls parasite burden and contributes to tissue damage, and what mechanisms underlie neurological and muscular pathologies that toxoplasmosis patients present with. This review aims to summarize recent important developments addressing these critical topics.

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Section: Toxoplasma Growth and Development Within Tissuesmentioning

confidence: 99%

Brains and Brawn: Toxoplasma Infections of the Central Nervous System and Skeletal Muscle

Wohlfert

Blader

Wilson

2017

Trends in Parasitology

116

111

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Section: -5mentioning

confidence: 99%

“…It has been shown that people might develop ocular disease years after postnatal infection with virulent strains of the parasite. 6 We therefore initiated a study to determine the proportion of persons infected during the outbreak who developed clinically apparent toxoplasmic retinochoroiditis since the last follow-up examinations in 1981, and to describe the nature of those lesions, if any.In 2002, approximately 25 years after the initial investigation, we again sought to conduct follow-up examinations on as many of the 37 people infected during the outbreak as possible. Questionnaires from the original 1977 investigation of the outbreak, sponsored by the Centers for Disease Control and Prevention (CDC), had been stored in a locked file cabinet at CDC; they contained names, addresses, and telephone numbers of those interviewed during the outbreak, and from these records, we attempted to locate each infected individual directly, through internet searches, or through family members.…”

mentioning

confidence: 99%

Follow-up of the 1977 Georgia Outbreak of Toxoplasmosis

Jones

Akstein

Hlavsa

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. In 1977, an outbreak of toxoplasmosis occurred among 37 persons associated with exposure to an indoor horse arena. Cat feces containing the organism were most likely stirred up when horses ran on the dirt floor, and were inhaled or ingested by riders and observers. After 25 or more years, we attempted to locate persons from the outbreak and offer them an eye examination. Of the 37 persons in the outbreak, 18 (49%) were located; four had died, and the remaining 14 agreed to an examination. Among the 14 persons examined, three (21%) were found to have lesions typical of toxoplasmic retinochoroiditis. If these three persons were the only ones with ocular disease among the 37 persons in the outbreak, the disease rate would still be high (8%). As a result of exposure to Toxoplasma gondii during this outbreak, a relatively high percentage of persons developed ocular disease.An outbreak of Toxoplasma gondii infection occurred in Georgia among individuals who had been in an indoor horse arena, and was presumed to be caused by inhalation or ingestion of dust contaminated by cat feces and stirred into the air by horses running on the dirt floor. 1 Although symptoms were nonspecific, an epidemiological study found that the prevalence of symptoms was significantly higher in case patients than in appropriate controls. Studies of the outbreak have been described in several subsequent publications. 1-5Follow-up ocular examinations were performed on 17 infected individuals 1 year after the outbreak; none had evidence of ocular disease, and none of the remaining 20 individuals were known to have ophthalmic symptoms. 5 Subsequent follow-up ocular examinations were performed on 25 individuals 4 years after the outbreak; one person had a single lesion consistent with toxoplasmic retinochoroiditis in the right eye.5 After treatment with antimicrobials and corticosteroids, the lesion resolved, leaving a chorioretinal scar.The high prevalence of systemic signs and symptoms at the time of the outbreak was postulated to be due to an infection caused by oocysts rather than tissue cysts, 4 and suggests that the outbreak was caused by a virulent strain of T. gondii. It has been shown that people might develop ocular disease years after postnatal infection with virulent strains of the parasite. 6 We therefore initiated a study to determine the proportion of persons infected during the outbreak who developed clinically apparent toxoplasmic retinochoroiditis since the last follow-up examinations in 1981, and to describe the nature of those lesions, if any.In 2002, approximately 25 years after the initial investigation, we again sought to conduct follow-up examinations on as many of the 37 people infected during the outbreak as possible. Questionnaires from the original 1977 investigation of the outbreak, sponsored by the Centers for Disease Control and Prevention (CDC), had been stored in a locked file cabinet at CDC; they contained names, addresses, and telephone numbers of those interviewed during the outbreak, and from these reco...

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“…It may affect the fetus, and clinical manifestations may occur during the intrauterine period or after birth, either in childhood or adulthood, with varying degrees of eye involvement [5,9,[11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Toxoplasmose ocular com reação em cadeia da polimerase positiva em sangue periférico – relato de dois casos, estado de São Paulo, Brasil

Barbosa¹,

Frederico²,

Previato³

et al. 2016

Sci Med

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Aims:To describe the use of polymerase chain reaction (PCR) in peripheral blood and demonstrate its importance in the clinical follow-up of patients with ocular toxoplasmosis. Case description: Two immunocompetent patients were clinically diagnosed with acute ocular toxoplasmosis. The routine clinical evaluation consisted of fundus examination using binocular indirect ophthalmoscopy, color fundus photography, fluorescein angiography, and spectral domain optical coherence tomography. The serological diagnosis was made by enzyme-linked immunosorbent assay (ELISA) and confirmed by enzyme-linked fluorescent assay (ELFA). The molecular diagnosis was made by PCR in peripheral blood using the B1 gene of Toxoplasma gondii as marker. The younger patient was male, had previous lesion in the right eye, complained of low visual acuity in the left eye and was under treatment. The older patient was male, had retinal detachment, and presented with sudden loss of acuity in the right eye. The fundus examination revealed chorioretinal scar in the left eye. IgG was reactive, IgM was non-reactive, and PCR was positive in the peripheral blood of both patients. New blood samples were collected for serological and molecular monitoring and PCR remained positive in both cases. Six weeks after treatment with oral sulfadiazine and pyrimethamine, the PCR yielded negative results. Conclusions:The results show that T. gondii antigens may be found in peripheral blood during ocular reactivations and that PCR may be a good tool for the follow-up of patients with ocular toxoplasmosis.KEY WORDS: Toxoplasma gondii; toxoplasmosis, ocular; retinochoroiditis; chorioretinitis; retinography; optical coherence tomography; PCR; polymerase chain reaction RESUMO Objetivos: Descrever o uso da reação em cadeia da polimerase (PCR) no sangue periférico e demonstrar sua importância no acompanhamento clínico de pacientes com toxoplasmose ocular. Descrição dos casos: Dois pacientes imunocompetentes foram clinicamente diagnosticados com toxoplasmose ocular aguda. Rotineiramente, a avaliação clínica foi feita por fundoscopia com o uso de oftalmoscópio binocular indireto, retinografia colorida, angiografia fluorescente e tomografia de coerência óptica espectral. A sorologia foi realizada por ensaio imunoenzimático (ELISA) e confirmada por ensaio imunoenzimático fluorescente ELFA (IgG, IgM). O diagnóstico molecular foi realizado por PCR em sangue periférico usando o gene B1 de Toxoplasma gondii como marcador. O paciente mais jovem era do sexo masculino, apresentava lesão prévia no olho direito, queixa de baixa acuidade visual no olho esquerdo e estava sob tratamento. O paciente mais velho era do sexo masculino, apresentava descolamento de retina e súbita diminuição de visão no olho direito. A fundoscopia revelou cicatriz coriorretiniana no olho esquerdo. Ambos os pacientes tinham IgG reagente, IgM não reagente e PCR positivo em sangue periférico. Novas amostras de sangue foram coletadas para monitoramento sorológico e molecular e a PCR permaneceu positiva e...

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Ocular Involvement Following Postnatally Acquired Toxoplasma gondii Infection in Southern Brazil: A 28-Year Experience

Cited by 47 publications

References 40 publications

Brains and Brawn: Toxoplasma Infections of the Central Nervous System and Skeletal Muscle

Brains and Brawn: Toxoplasma Infections of the Central Nervous System and Skeletal Muscle

Follow-up of the 1977 Georgia Outbreak of Toxoplasmosis

Toxoplasmose ocular com reação em cadeia da polimerase positiva em sangue periférico – relato de dois casos, estado de São Paulo, Brasil

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