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Toxoplasmosis

Jonathan MacClements, MD, FAAFP Reviewed 06/2019
 


BASICS

  • Toxoplasma gondii is an obligate intracellular protozoan parasite.

  • Most common latent protozoan infection

  • Clinically significant disease typically manifests only in pregnancy or in an immunocompr...

DIAGNOSIS

HISTORY

  • Congenital toxoplasmosis

    • Clinical presentation varies widely; 80% of patients are asymptomatic at birth.

    • Classic triad (uncommon): chorioretinitis, hydrocephalus, cerebral calcification...

TREATMENT

GENERAL MEASURES

Immunocompetent patients usually require no treatment. 

MEDICATION

First Line

ALERT

Important: All pyrimethamine-containing regimens should include leucovorin (folinic acid 10 to...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

Precautions 
  • Monitor for bone marrow, renal, or liver toxicity.

  • Good hydration: Sulfadiazine is poorly soluble and may crystallize in the urine.

  • Wa...

REFERENCES

1
Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bull World Health Organ.  2013;91(7):501–508. [View Abstract on OvidMedline]
2
Montoya ...

ADDITIONAL READING

  • Alday P, Doggett J. Drugs in development for toxoplasmosis: advances, challenges, and current status. Drug Des Devel Ther.  2017;11:273–293. [View Abstract on OvidMedline]

  • Arant...

CODES

ICD10

  • B58.9 Toxoplasmosis, unspecified

  • P37.1 Congenital toxoplasmosis

  • B58.2 Toxoplasma meningoencephalitis

  • B58.00 Toxoplasma oculopathy, unspecified

ICD9

  • 130.9 Toxoplasmosis, unspecified

  • 771.2 Other co...

CLINICAL PEARLS

  • Toxoplasmosis is often asymptomatic in immunocompetent patients.

  • Primary prevention is important, particularly for pregnant women and immunodeficient patients.

  • The most common manifestat...

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