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At least 757 records · Page 42Linked to original sources
PubMed1994

Cytologic identification of Toxoplasma gondii from vitreous fluid.

A 75-year-old man presented with a diffuse necrotizing retinitis in his left eye. Although his condition was initially diagnosed as acute retinal necrosis syndrome, the serologic test results were interpreted as indicating recurrent toxoplasmosis retinitis. Cytopathologic examination of the vitreous following pars plana vitrectomy for repair of a retinal detachment revealed Toxoplasma organisms. The observation of Toxoplasma gondii in the vitreous specimen confirmed our clinical diagnosis and helped guide treatment of the patient.

Aged↗
PubMed1982

Toxoplasmosis infection associated with raw goat's milk.

In October 1978, a large family cluster of acute toxoplasmosis was identified in northern California. Indirect fluorescent IgM antibody tests showed that ten of 24 members of an extended family had serological evidence of acute Toxoplasma infection. The index case had retinochoroiditis; the other nine persons had asymptomatic infections. All ten seropositive persons had recently consumed raw goat's milk from the family herd as compared with no consumption of raw milk by the 14 persons with negative results. No dietary item or other risk factors were as strongly associated with positive serological test results as raw milk consumption. Although ingestion of soil-transmitted oocysts could not be ruled out unequivocally as the source of infection, the data suggest that drinking raw milk from infected goats might be another possible vehicle for the transmission of toxoplasmosis.

Adolescent↗
PubMed1995

Retinal vascular involvement in acute toxoplasmic retinochoroiditis.

The present study deals with the retinal vascular involvement in 64 patients with toxoplasmic retinochoroiditis during the acute phase of the disease and its evolution. Vascular involvement was noted in all 64 eyes during the acute phase of the disease. In 59 (92%) out of 64 cases the vascular involvement was located in the same retinal quadrant as the active toxoplasmic lesion. In the remaining 5 eyes (8%) the vascular participation was found in all four retinal quadrants. In 3 (5%) out of 64 cases, the vascular infiltration was extremely severe and resulted in retinal vascular obstruction. In all three cases the vessel traversed the active toxoplasmic lesion. In 35 (55%) out of 64 patients the initial vascular picture changed in the course of the acute phase of the disease. In these patients, the lesions had extended to the adjacent vessels or to other parts of the involved vessel. In the further course of the evolution of the active toxoplasmic lesion, the vascular involvement did not persist indiscriminately. It was noted that in 14 (22%) out of 64 cases the vascular lesions gradually regressed and eventually disappeared together with the active toxoplasmic lesion and the formation of the retinochoroidal scar. In the remaining 50 (78%) out of 64 cases the vascular involvement either disappeared after the establishment of the retinochoroidal scar in 3-12 months (29 cases) or remained permanently (21 cases).

Acute Disease↗
PubMed1992

Analysis of the electroretinogram in toxoplasma retinochorioiditis.

The decision to use therapy in toxoplasma retinochorioiditis depends on the location of the active lesion and the presence of vitreous activity. In eyes with dense vitreous clouding it can be difficult to see whether the macular region is involved or not. In theory the localisation of a lesion can be estimated on the basis of the flash ERG. The standard flash electroretinogram was recorded in 23 patients with inactive toxoplasma retinochorioiditis lesions in the retina. In 17 cases a lesion was present within the central 12 degrees of the visual field, 8 of these had a reduced photopic ERG. In 15 patients lesions were found outside the central 12 degrees, in 8 of whom the scotopic ERG was reduced. We conclude that the ERG can be of use in indicating the scar location in patients with dense vitreous clouding.

Adolescent↗
PubMed1992

Biological modifications of the vitreous in intraocular parasitosis: preliminary study.

In intraocular parasitosis the immunologic reactions in the vitrectomy-fluids depend on the parasitic agent: there is a lymphocytical reaction without any IgE production in toxoplasmic chorioretinitis, whereas there is a strong hypersensitivity reaction with a local IgE production as well as the presence of eosinophils and an antigenic stimulation in fluids with toxocara parasitosis. The electrophoretic patterns are quite similar in both cases.

Adolescent↗
PubMed1987

Bone-marrow transplantation and toxoplasmic retinochoroiditis.

A 33-year-old woman underwent bone-marrow transplantation following radiation and chemotherapy for chronic myelocytic leukemia (CML); immunosuppressive therapy was continued for graft-versus-host disease. Five months after successful transplantation, she developed necrotizing retinitis in both eyes with rapid progression over the following weeks. Due to her immunosuppressed state the patient developed pneumonia and died. Postmortem evaluation of the retinal lesions in both eyes disclosed infection by Toxoplasma gondii, which was also found in the brain and myocardium. Multiple viable toxoplasmic cysts were observed at the transition zone from a necrotic to a normal retina. Additionally, cysts of Toxoplasma gondii a normal retina. Additionally, cysts of Toxoplasma gondii were seen in the adjacent intact retina and in areas of necrosis with almost complete absence of retinal or choroidal inflammation. Toxoplasmosis should therefore be considered along with fungi and viruses in the differential diagnosis of necrotizing retinochoroiditis in immunocompromised patients.

Adrenal Cortex Hormones↗
PubMed1989

Aqueous humor analysis as a diagnostic tool in toxoplasma uveitis.

Analysis of local toxoplasma antibody production to confirm a suspected clinical diagnosis of toxoplasma chorioretinitis is a valuable diagnostic tool. Determination of toxoplasma antibodies in the blood of the patient is of limited use. When blood toxoplasma tests are negative this indicates that toxoplasma as a causative organisms in the pathogenesis of uveitis is unlikely. A positive blood test is a sensitive test (100% patients positive) but not a specific test since so many healthy individuals already have undergone subclinical infection and have acquired humoral immunity against the parasite. We analysed 93 paired aqueous and serum samples for toxoplasma antibodies and total IgG and determined the Goldmann-Wittmer coefficient. In patients retrospectively diagnosed as having toxoplasma chorioretinitis 16 out of 22 had a positive coefficient, indicating local parasite antibody production. In one patient with AIDS we also found a positive toxoplasma coefficient. Three out of 15 patients with posterior uveitis of unknown origin also had a positive coefficient. None of the cataract patients tested (n = 32) had a positive coefficient. Major drawbacks of aqueous humor analysis are that a false negative antibody coefficient can occur when a massive blood aqueous barrier breakdown has occurred.

Antibodies, Protozoan↗
PubMed1990

Diffuse necrotizing retinochoroiditis in a child with AIDS and toxoplasmic encephalitis.

We examined a child with a human immunodeficiency virus (HIV) infection who at 15 months of age developed acute encephalitis, followed 1 week later by a diffuse, uniocular retinochoroiditis. The clinical picture in the right eye was characterized by the occurrence of some intraretinal hemorrhages; punctate, yellow-white, outer retinal lesions temporal to the macula; and a quadrantal, white area of necrotic retina located superotemporally. - The vitreous was remarkably clear, and the left eye was normal. Fluorescein angiography revealed small spots of late hyperfluorescence, vasculitis in the posterior pole, and a persistently hypofluorescent quadrantal superotemporal area. Toxoplasma IgM antibodies that were absent 1 week after birth became detectable in the serum and the cerebrospinal fluid. Serological testing for cytomegalovirus was negative. Neurological signs improved on a specific therapy (pyrimethamine and sulfamethopirazine), but the patient died 2 months later of disseminated cytomegalovirus infection.

Acquired Immunodeficiency Syndrome↗
PubMed1997

[Analysis of aqueous humor in intraocular toxoplasmosis].

BACKGROUND: Despite many clinical examinations and laboratory tests, the cause of uveitis is very often not discovered. The examination of local intraocular antibody production is a valuable additional diagnostic means. PATIENTS AND METHODS: Aqueous humor was obtained from 46 eyes with severe uveitis: retinochorioiditis (n = 27), intermediate uveitis (n = 11), iridocyclitis (n = 5), and panuveitis (3). With the enzyme-linked immunosorbent assay (ELISA) the antibodies against Toxoplasma gondii were measured in aqueous humor and serum and the intraocular antibody production was calculated by the formation of an antibody index (AI). As the AI values are corrected for possible polyspecific immune response, the AI index is more sensitive than the Goldmann-Witmer index. RESULTS: An intraocular antibody synthesis against T. gondii could be confirmed in 20 eyes. The serum antibody concentration against T. gondii was in the reference range in 45 patients and only one patient had a very high increase of antibodies. In nine of 20 eyes, intraocular synthesis of antibodies against T. gondii was unexpected due to the lack of clinical evidence. CONCLUSIONS: The aqueous humor analysis is more reliable than the proof of serum antibodies, and it helps to increase the number of eyes with uveitis in which a specific therapy can be established.

Animals↗
PubMed2004

Photodynamic therapy-treated choroidal neovascular membrane secondary to toxoplasmic retinochoroiditis.

PURPOSE: To report the result of photodynamic therapy with Visudyne (PDT) on a child with choroidal neovascular membrane (CNV) secondary to toxoplasmic retinochoroiditis. METHODS: An 11-year-old child with a unilateral lowering of visual acuity secondary to an extrafoveal choroidal neovascular membrane was submitted to PDT. RESULTS: One week after PDT, the patient's vision had improved from 10/160 to 20/70, with marked improvement in the angiographic findings. The CNV evolved with decreasing of leakage until 45 days after operation, when it regressed to a chorioretinal scar formation, with final vision of 20/25. CONCLUSION: PDT promoted an early recovery of visual acuity in an eye with choroidal neovascularization secondary to toxoplasmic retinochoroiditis.

Antiprotozoal Agents↗