Congenital toxoplasmosis. III. Ocular signs of the disease in state schools for the blind.
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Choroiditis↗
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Results for “TOXOPLASMOSIS, OCULAR”
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Clinical patterns and characteristics of uveitis in a tertiary center for uveitis in China.
PURPOSE: To address the clinical pattern and characteristics of uveitis in a tertiary center for uveitis in China and compare the similarity and difference in the distribution of uveitis entities between China and other countries. METHODS: A retrospective study was performed on the patients with uveitis referred to the Zhongshan Ophthalmic Center from January 1996 to December 2003. The clinical data including category, etiology, gender, and the age of the patients at uveitis presentation were analyzed and compared with studies published previously from other countries. RESULTS: There were 902 male and 850 female patients in our series. The mean age of these patients at uveitis presentation was 33.8 +/- 16.5 years. Anterior uveitis (800, 45.6%) was the most common anatomical entity, followed by panuveitis (727, 41.5%), posterior uveitis (119, 6.8%), and intermediate uveitis (106, 6.1%). Further classification with the etiology criteria revealed 16 entities in anterior uveitis, with idiopathic anterior uveitis being the most common entity (473, 27.0%). Twelve entities were identified in panuveitis, of which Behçet disease (289, 16.5%) and Vogt-Koyanagi-Harada (VKH) syndrome (278, 15.9%) were the predominant ones. No specific entity was recognized in the intermediate uveitis group. Although a number of specific entities were identified in posterior uveitis, toxoplasmosis was noted in only two patients in this group. CONCLUSIONS: Idiopathic anterior uveitis, Behçet disease, and VKH syndrome are the most common entities of uveitis in China. Ocular toxoplasmosis, ocular histoplasmosis, and birdshot retinochoroidopathy are less common or absent in China.
Adolescent↗
[Seroepidemiology of toxoplasmosis and ocular evaluation by Amsler grid in patients from the rural area treated at the Jaguapitã county health center, Paraná State, Brazil].
In this study, we collected serum from 82 randomly selected patients from a rural area in Jaguapitã county, Paraná State. All sera were subjected to indirect immunofluorescence assay (IFA) to detect IgG antibodies against T. gondii. Serum titers >/=+ 16 were considered positive. Of the 82 evaluated sera, 68 (82.9%) were positive to toxoplasmosis and 14 (17.1%) were non-reactive. The most common titers found were 64 (23/33.8%) and 256 (16/23.5%), the highest titer being 4096 (8/11.8%). The 82 patients were also evaluated by the Amsler Grid test, with 22 (26.8%) patients presenting at least one alteration in this test. Masculinity was found to be a protection factor in the Amsler grid test (OR = 0.21 0.04 < OR < 0. 86 chi2 = 4,98 p = 0,02). There were no significant statistical differences related to the epidemiological investigation. We concluded that T. gondii has a wide distribution in the population studied.
Adolescent↗
[CONGENITAL TOXOPLASMOSIS AND ITS OCULAR LESIONS].
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Eye↗
Miliary toxoplasmic retinitis in acquired immunodeficiency syndrome.
A unique pattern of bilateral miliary retinitis due to ocular toxoplasmosis developed in a patient in the late stages of acquired immunodeficiency syndrome. Results of serologic tests for toxoplasmosis remained negative throughout the clinical course of his ocular disease. The retinitis was unresponsive to a brief course of anti-toxoplasmosis therapy. At autopsy, the histopathologic material was consistent with toxoplasmic retinitis and the DNA polymerase chain reaction was positive for toxoplasmosis. Recognition of this pattern of retinitis is important in the appropriate treatment of immunosuppressed patients with retinitis.
AIDS-Related Opportunistic Infections↗
Clindamycin therapy for toxoplasmosis.
Clindamycin hydrochloride hydrate (Cleocin), a semisynthetic antibiotic shown experimentally to be effective in ocular toxoplasmosis in the rabbit, was used in the treatment of four patients with active retinochoroiditis secondary to toxoplasmosis. The drug was administered subjunctivally on alternate days for 30 days. Both subjective and objective evidence indicated beneficial results in these patients during the first 30 days. One of the four did not respond during the first 30 days but did respond during an extended period. One of those who responded initially had exacerbations when the drug was stopped and required treatment.
Adolescent↗
Outer retinal toxoplasmosis.
Toxoplasma gondii is a neurotrophic organism that affects the neurosensory retina in humans. Typical ocular toxoplasmosis involves the inner retina and is associated with marked vitreous reaction. A subset of this clinical spectrum is characterized by gray-white macular lesions at the level of the outer retina. This outer retinal lesion is associated with little or no vitreous reaction. The authors report five additional cases of outer retinal toxoplasmosis. Recognition of this variation is important; prompt treatment, before serologic confirmation, resulted in marked visual improvement in all cases.
Adolescent↗
Recurrent secondary frosted branch angiitis after toxoplasmosis vasculitis.
PURPOSE: To describe a case of recurrent frosted branch angiitis after treatment of ocular toxoplasmosis. METHODS: In a 6-year-old boy, we found perivascular, creamy, patchy, retinal sheathing in both eyes without any focal necrotizing retinochoroiditis or scarring. IgM antibodies for toxoplasma gondii were also found. The patient was treated with antitoxoplasmosis medication and a systemic steroid. RESULTS: Several years after treatment of the toxoplasmosis, frosted branch angiitis occurred twice without any retinal scarring or serological evidence of toxoplasmosis. After systemic steroid therapy, the angiitis improved without further complications. CONCLUSIONS: Toxoplasmic retinal vasculitis should be considered as a cause of frosted branch angiitis.
Antiprotozoal Agents↗
Some remarks on the immunopathology of toxoplasmic uveitis.
Data obtained from prospective studies of congenital toxoplasmosis and from serological examination of patients with uveitis suggest that ocular toxoplasmosis is mostly congenital in origin. It is mainly related to the immunological clearance of residual cysts persisting after a subclinical congenital toxoplasmosis.
Adolescent↗
[The chorioretinal location of Toxoplasma infection].
Considered rare and occurring only in immunocompromised patients or patients with severe infection, Toxoplasma gondii chorioretinitis--as a unique presenting sign of toxoplasmosis appears to occur with increased frequency over the last few years in immunocompetent patients. The typical clinical picture (central chorioretinal lesion with recurrent vasculitic reactions) and positive IgG Toxoplasma gondii serology confirmed our diagnosis. Negative Toxoplasma IgG serology in the mothers of 2 patients excluded the possibility of congenital toxoplasmosis. Clinicians should be aware of the possibility of increased frequency of ocular toxoplasmosis in immunocompetent patients.
Adolescent↗
Ocular involvement in systemic toxoplasmosis: a case report.
We report a case of adult acquired toxoplasmosis with ocular involvement in a 29 year old immunocompetent female. The patient had an illness for approximately 3 weeks characterized by lymphadenopathy, malaise and rash that was diagnosed serologically as toxoplasmosis. At the time of diagnosis, she developed signs and symptoms of retino choroiditis. She had serologic evidence of cytomegalovirus (CMV) infection as well as the recent toxoplasma infection. The patient was treated with pyrimethanime, sulfadiazone and folic acid for 6 weeks, plus prednisone for 4 weeks, during which the illness resolved. Toxoplasmosis is a protozoan infection that occurs worldwide, and is the most common cause of infectious retinochoroiditis in otherwise healthy individuals. Most cases of Toxoplasma infection in the immunocompetent adult are asymptomatic. The most common clinical presentation is localized lymphadenopathy. Ocular signs, which are common in congenitally acquired toxoplasmosis, may rarely be the only manifestation of acquired systemic toxoplasmosis. It has been suggested that concomitant infection with a DNA virus, such as CMV or herpes simplex virus, may facilitate the penetration of protozoa into cells, or that antigenic stimulation from toxoplasma antigens may activate endogenous latent CMV in the recipient. The occurrence of ocular involvement during toxoplasmosis and its association with a DNA virus is reviewed.
Adult↗
Prospective observation of vascular anastomoses between the retina and choroid in recurrent toxoplasmosis.
Prospective angiographic observations demonstrated the formation of both choroidoretinal arteriolar anastomoses as well as retinochoroidal venular anastomoses in the ocular fundus of a young man with recurrent ocular toxoplasmosis.
Adult↗
Meningo-encephalitis accompanying retinochoroiditis in a murine model of congenital toxoplasmosis.
A histopathological study of the brains of adult mice infected in utero with Toxoplasma gondii and presenting manifestations of ocular toxoplasmosis is reported. All brains contained Toxoplasma tissue cysts. A sub-acute/chronic meningo-encephalitis was the main feature of the inflammatory response in the brain. Microscopical features suggest that autoimmune processes may play a part in the disease. We suggest that our mouse model will provide a simple and inexpensive tool for the investigation of histopathological processes in the CNS resulting from congenital Toxoplasma infection.
Animals↗
Diffuse toxoplasmic retinochoroiditis in a patient with AIDS.
Ocular toxoplasmosis typically presents as a focal necrotizing retinochoroiditis. We report a case of diffuse necrotizing retinochoroiditis due to toxoplasmosis in a patient with the acquired immunodeficiency syndrome (AIDS). The appearance at initial presentation was similar to the acute retinal necrosis syndrome. We recommend that toxoplasmosis be considered in the differential diagnosis of diffuse retinal necrosis in patients with AIDS. Although systemic disseminated toxoplasmosis is not rare in AIDS, this is, to our knowledge, the first reported case of diffuse ocular involvement.
Acquired Immunodeficiency Syndrome↗
[Preretinal neovessels in toxoplasmic uveitis].
Preretinal and prepapillary new vessels developed in a case of severe ocular toxoplasmosis. Fluorescein angiography failed to demonstrate any area of ischemic retina. Neovascularization disappeared with medical treatment and ocular inflammation resolution.
Child↗
Toxoplasmosis.
PURPOSE OF REVIEW: The purpose of this review is to update the latest information on a long-recognized infectious disease, ocular toxoplasmosis. RECENT FINDINGS: Topics include how the disease is acquired, how to make a clinical diagnosis, and what laboratory tests to order when the diagnosis is not clear. New insights into the genetic make-up of the parasite and new treatment alternatives are discussed. SUMMARY: Recent findings are updated on the epidemiologic status of the disease, methods for correct diagnosis of unusual presentations, and alternative therapies.
Animals↗
Toxoplasmosis transmitted to a newborn from the mother infected 20 years earlier.
PURPOSE: To present a case of congenital toxoplasmosis in a newborn whose mother had a 20-year history of a chorioretinal macular scar and positive serology for toxoplasmosis. DESIGN/METHODS: Case report. SETTING/RESULTS: A 38-year-old woman who had been treated for ocular toxoplasmosis 20 years earlier delivered a newborn who presented with a focal necrotizing retinochoroiditis characteristic of toxoplasmosis, as well as positive immunoglobulin (Ig) G and M serology for toxoplasmosis. The workup was negative for other entities. CONCLUSION: This case suggests that women with old retinal scars due to toxoplasmosis and long-standing IgG antibodies to toxoplasmosis are also at risk of transmitting this disease to the fetus.
Adult↗
Serologic tests in the diagnosis of presumed toxoplasmic retinochoroiditis.
We treated three patients who had documented Toxoplasma retinochoroiditis and negative immunofluorescent antibody toxoplasmosis titers (titer less than 1:16), positive Sabin-Feldman dye titers of 1:64, 1:16, and 1:64 in the three patients, respectively, and a positive enzyme-linked immunoassay titer of 1:256 in the one patient tested. In patients with negative immunofluorescent antibody toxoplasmosis titers, we recommend obtaining Sabin-Feldman or enzyme-linked immunoassay titers, or both, before excluding the diagnosis of ocular toxoplasmosis.
Adolescent↗