Severe acute multi-systemic failure with bilateral ocular toxoplasmosis in immunocompetent patients from urban settings in Colombia: Case reports

Cortés, Diana Alejandra; Aguilar, María Camila; Ríos, Hernán Andrés; Rodriguez, Francisco J.; Montes, Kelly; Gómez‐Marín, Jorge Enrique; de-la-Torre, Alejandra

doi:10.1016/j.ajoc.2020.100661

Cited by 11 publications

(3 citation statements)

References 14 publications

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“…Toxoplasma gondii is widespread in South America, and in addition to Brazil, non-archetypal genotypes have been reported in Colombia [ 38 ] and Argentina [ 39 , 40 ]. Pérez-Grisales et al [ 44 ] reviewed 8103 reports of T. gondii in Colombia, of which 86% were from humans and 82% from urban areas.…”

Section: Genotyping Of Non-archetypal Strains Of T Gondiimentioning

confidence: 99%

Genetic diversity of Toxoplasma gondii in South America: occurrence, immunity, and fate of infection

Brito,

de Lima Bessa,

Bastilho

et al. 2023

Parasites Vectors

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Toxoplasma gondii is an intracellular parasite with a worldwide distribution. Toxoplasma gondii infections are of great concern for public health, and their impact is usually most severe in pregnant women and their foetuses, and in immunocompromised individuals. Displaying considerable genetic diversity, T. gondii strains differ widely according to geographical location, with archetypal strains predominantly found in the Northern Hemisphere and non-archetypal (atypical) strains, with highly diverse genotypes, found mainly in South America. In this review, we present an overview of the identification and distribution of non-archetypal strains of T. gondii. Special attention is paid to the strains that have been isolated in Brazil, their interaction with the host immunological response, and their impact on disease outcomes. The genetic differences among the strains are pivotal to the distinct immunological responses that they elicit. These differences arise from polymorphisms of key proteins released by the parasite, which represent important virulence factors. Infection with divergent non-archetypal strains can lead to unusual manifestations of the disease, even in immunocompetent individuals. Graphical Abstract

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Section: Genotyping Of Non-archetypal Strains Of T Gondiimentioning

confidence: 99%

Genetic diversity of Toxoplasma gondii in South America: occurrence, immunity, and fate of infection

Brito,

de Lima Bessa,

Bastilho

et al. 2023

Parasites Vectors

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“…Es wird immer wieder berichtet, dass einzelne Patienten auf die primär verord- nete Therapie nicht adäquat ansprechen [3,5,7] Nur in Ausnahmefällen wird die intravitreale Injektion als therapeutische Option erwogen [16]. Dies ist in Anbetracht der Pathophysiologie der Erkrankung sinnvoll und steht in Einklang mit vergleichbaren Erhebungen, die dies als selektives Verfahren ansehen [3,21].…”

Section: » Seit 2007 Hat Eine Deutlicheunclassified

Diagnostik und Behandlung der okulären Toxoplasmose

2022

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Zusammenfassung Hintergrund Die okuläre Toxoplasmose (OT) ist die häufigste infektiöse Ursache einer posterioren Uveitis. Diese Erhebung soll das derzeitige diagnostische und therapeutische Vorgehen bei OT in Deutschland evaluieren. Material und Methoden Ein detaillierter Fragebogen mit spezifischen Patientenbeispielen wurde im Juli 2021 an die Mitglieder der Sektion Uveitis der Deutschen Ophthalmologischen Gesellschaft (DOG) und der Retinologischen Gesellschaft (RG) versandt. Ergebnisse Der Fragebogen wurde von 53 (29 RG und 24 DOG) Ophthalmologen beantwortet. Sechzehn (30 %) Befragte arbeiten in einer Praxis, 18 (34 %) in einer Klinik und 19 (36 %) in einer Universitätsklinik. Neun (17 %) Augenärzte (AÄ) betreuen weniger als 50, 28 (53 %) 50 bis 200 und 16 (30 %) mehr als 200 Uveitispatienten pro Jahr. Der klinische Befund gilt weiterhin als Goldstandard (87 %) für die Diagnose der OT und wird bei Erstmanifestation in 60 % durch spezifische serologische Antikörperuntersuchungen unterstützt. Eine Diagnose allein anhand des klinischen Befundes stellen 10 von 53 (19 %) AÄ, 25 (47 %) Befragte stützen sich auf einen Ig(Immunglobulin)M-Test, 6 (11 %) erwarteten einen IgG-Titer-Anstieg und einer (2 %) den Nachweis spezifischer IgA-Antikörper. Die Mehrheit (n = 28 [53 %]) der AÄ würde die Diagnose im Zweifelsfall durch eine Vorderkammerpunktion sichern; dabei präferieren 20 (38 %) die Polymerasekettenreaktion (PCR), 3 (6 %) die Bestimmung des Goldmann-Witmer-Koeffizienten und 5 (9 %) eine Kombination beider Verfahren. Zur Therapie wurde am häufigsten Clindamycin eingesetzt (n = 21 [40 %]), gefolgt von Pyrimethamin/Sulfadiazin (n = 17 [32 %]) und Trimethoprim + Sulfamethoxazol (TMP/SMX) (n = 10 [19 %]); Letzteres wird auch (n = 40 [75 %]) zur Sekundärprophylaxe eingesetzt. Schlussfolgerungen Die Ergebnisse lassen neben dem klinischen Befund als „Goldstandard“ zur Diagnosestellung kein einheitliches Vorgehen zu Diagnose und Therapie der OT erkennen. Die hohe Nachfrage nach Serum-IgM-Antikörpern weist auf eine weitverbreitete Unsicherheit über die Bedeutung serologischer Befunde hin. Dies ist angesichts der weiterhin hohen Seroprävalenz in Deutschland kritisch zu werten.

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“…Historically, infection with T. gondii has been long considered essentially asymptomatic or benign, except for certain risk groups, such as the developing fetus in the case of congenital infection, and immunocompromised patients for whom toxoplasmosis can have severe health consequences either during primo-infection or reactivation [4]. However, clinical toxoplasmosis has also been reported in immunocompetent individuals, mainly in the form of ocular lesions and multivisceral involvement [5][6][7]. The prevalence of clinical toxoplasmosis, its clinical forms and their severity substantially vary worldwide [8].…”

Section: Introductionmentioning

confidence: 99%

Toxoplasma gondiifrom Gabonese forest, Central Africa: first report of an African wild population

Galal,

Fritz,

Becquart

et al. 2024

Preprint

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The protozoan Toxoplasma gondii is a ubiquitous and highly prevalent parasite that can theoretically infect all warm-blooded vertebrates. In humans, toxoplasmosis causes infections in both immunodeficient and immunocompetent patients, congenital toxoplasmosis, and ocular lesions. These manifestations have different degrees of severity. Clinical severity is determined by multiple factors, including the genotype of the T. gondii strain involved in the infection. T. gondii exhibits remarkable genetic diversity, which varies according to geography and ecotype (domestic or wild). Previous studies have demonstrated that wild strains of T. gondii are of particular epidemiological interest, as they have been associated with more severe forms of toxoplasmosis in different regions of the world. However, no data on wild strains of T. gondii are available from Africa. In this study, we describe for the first time a wild T. gondii population from Africa. Wild animals from the forest environment of Gabon, Central Africa, were screened for chronic infection with T. gondii using quantitative PCR. The infecting T. gondii strains were genotyped whenever possible by the analysis of 15 microsatellite markers and by whole-genome sequencing. A new genotype was identified and was found to be highly divergent from previously described T. gondii populations worldwide, including those from the domestic environment in Gabon. Whole genome-based analyses indicated that this strain was genetically closer to a wild Pan-American population than to domestic African populations. This discovery marks the first description of a wild T. gondii population in Africa. The role of wild T. gondii strains in the incidence of severe toxoplasmosis in Africa remains unclear and requires further investigation.

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Severe acute multi-systemic failure with bilateral ocular toxoplasmosis in immunocompetent patients from urban settings in Colombia: Case reports

Cited by 11 publications

References 14 publications

Genetic diversity of Toxoplasma gondii in South America: occurrence, immunity, and fate of infection

Genetic diversity of Toxoplasma gondii in South America: occurrence, immunity, and fate of infection

Diagnostik und Behandlung der okulären Toxoplasmose

Toxoplasma gondiifrom Gabonese forest, Central Africa: first report of an African wild population

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