RONALD TAMBUNAN

PREFACE
 TOXOPLASMOSIS: TOXOPLASMA GONDII
 1909: NICOLLE & MANCEAUX DISCOVERED THE
ORGANISM IN THE GUNDI (CTENODACTYLUS
GUNDI)
 FOODBORNE ILLNESS
 CAUSING DEATH ESPECIALLY TO PREGNANT
WOMEN AND IMMUNE COMPROMISED
INDIVIDUALS

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 EPIDEMIOLOGY
 IN VARIOUS PLACES AROUND THE WORLD: UP
TO 95% POPULATIONS HAVE BEEN INFECTED W/
TOXOPLASMA
 INFECTION IS OFTEN HIGHEST IN AREAS THAT
HAVE HOT, HUMID CLIMATES, & LOWER
ALTITUDES
 TRANSMISSIONS: FOODBORNE, ZOONOTIC,
CONGENITAL, BLOOD TRANSF, ORGAN TRANSPL

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 FOODBORNE
 EATING UNDERCOOKED, CONTAMINATED
MEATS: PORK, LAMB, & VENISON
 NOT WASHING HAND
 CONTAMINATED UTENSILS: KNIVES, CUTTING
BOARDS, ETC

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 ZOONOTIC
 CAT’S LITTER BOX
 ACCIDENTALLY
TOUCHING CAT’S
FECES
 CONTAMINATED SOIL
 CONTAMINATED
WATER

KEY WORD: CAT

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 MOTHER TO CHILD
TRANSMISSION (CONGENITAL)
 WOMAN WHO NEWLY INFECTED W/
TOXOPLASMA DURING PREGNANCY CAN PASS
THE INFECTION TO HER UNBORN CHILD
(CONGENITAL INFECTION)
 THE WOMAN MAY NOT HAVE SYMPTOMS
 FOR THE UNBORN CHILD: DISEASES OF NERVES
SYSTEM & EYES

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LIFE CYCLE

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LIFE CYCLE

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 EXPLANATION
 DEFINITIVE HOST: DOMESTIC CATS
 UNSPORULATED OOCYSTS ARE SHED IN A LARGE NUMBER IN
THE CAT’S FECES FOR 1-2 WEEKS
 IN 1-5 DAYS, OOCYST WILL SPORULATE IN THE ENVIRONMENT &
BECOME INFECTIVE
 INTERMEDIATE HOSTS BECOME INFECTED AFTER INGESTING
MATERIAL CONTAMINATED W/ SPORULATED OOCYST
 OOCYST TRANSFORM INTO TACHYZOITES SHORTLY AFTER
INGESTION
 TACHYZOITES LOCALIZED IN NEURAL & MUSCLE TISSUE &
DEVELOP INTO TISSUE CYST BRADYZOITES

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 EXPLANATION
 CATS BECOME INFECTED AFTER CONSUMING
INTERMEDIATE HOST OR DIRECTLY BY
INGESTION SPORULATED OOCYSTS

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 EXPLANATION
 HUMAN CONSUMED ANIMALS THAT ALREADY
INFECTED:
1. EATING UNDERCOOKED MEAT HARBORING
TISSUE CYSTS
2. CONSUMING FOOD OR WATER CONTAMINATED
W/ CAT FECES
3. BLOOD TRANSF OR ORGAN TRANSP
4. TRANSPLACENTALLY

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 EXPLANATION
 IN THE HUMAN: PARASITES FORM TISSUE CYST,
MOST COMMONLY IN SKELETAL MUSCLE,
MYOCARDIUM, BRAIN, & EYES
 THESE CYSTS MAY REMAIN THROUGHOUT THE
LIFE OF THE HOST
 DIAGNOSIS: SEROLOGY, OBSERVED TISSUE CYSTS
VIA STAINED BIOPSY, DETECTING T. GONDII DNA
IN AMNIOTIC FLUID USING PCR

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ULTRASTRUCTURE OF T. GONDII

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 SYMPTOMS
 GENERAL:
1. OFTEN DON’T HAVE SYMPTOMS BECAUSE THE
IMMUNE SYSTEM USUALLY KEEPS THE
PARASITE FROM CAUSING ILLNESS
2. MILD W/ “FLU-LIKE” SYMPTOMS, LAST FOR
SEVERAL WEEKS & THEN GO AWAY
3. LYMPHADENOPATHY
4. PARASITE REMAINS IN AN INACTIVE STAGE

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 SYMPTOMS
 PREGNANCY
1. CONGENITAL TRANSMISSION
2. MISCARRIAGE
3. STILLBORN
4. BORN W/ ABNORMAL ENLARGEMENT OR
SMALLNESS OF THE HEAD
5. POTENTIAL VISION LOSS (OCULAR
TOXOPLASMOSIS)
6. MENTAL DISABILITY
7. SEIZURES
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RETINOCHOROIDAL SCARRING

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 OCULAR TOXOPLASMOSIS
 RETINOCHOROIDITIS (INFLAMMATION OF THE
RETINA  RETINOCHOROIDAL SCARRING)

1. EYE PAIN
2. PHOTOPHOBIA
3. TEARING OF THE EYES
4. BLURRED VISION
5. BLINDNESS

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 IMMUNOCOMPROMISED
(DON’T HAVE AIDS)
 CNS TOXOPLASMOSIS: SEIZURE,
DYSEQUILIBRIUM, CRANIAL NERVE DEFICIT,
ALTERED MENTAL STATUS, FOCAL
NEUROLOGICAL DEFICITS, HEADACHE
 ENCEPHALITIS, MENINGOENCEPHALITIS, OR
MASS LESIONS
 HEMIPARESIS
 VISUAL CHANGES
 MYOCARDITIS
 TOXOPLASMOSIS PNEUMONITIS
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 IMMUNOCOMPROMISED
(AIDS)
 ALTERED MENTAL STATE
 SEIZURES
 WEAKNESS
 CRANIAL NERVE DISTURBANCES
 SENSORY ABNORMALITIES
 CEREBELLAR SIGNS
 MENINGISMUS
 MOVEMENT DISORDERS
 NEUROPSYCHIATRIC MANIFESTATIONS
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 DIAGNOSIS
 SEROLOGIC: IgG & IgM
 DIRECT OBSERVATION:
STAINED TISSUE
SECTIONS, CSF,
BLOOD
 MOLECULAR:
PARASITE’s DNA IN
AMNIOTIC FLUID

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TACHYZOITES (GIEMSA
STAINED)

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TACHYZOITES IN CELL LINE

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 TREATMENT
 EMERGENCY
A, B, C, & FLUID RESUSCITATION
NEUROIMAGING
BROAD SPECTRUM ANTIMICROBIAL

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 CONSULTATIONS
 PARASITOLOGIST
 OPHTALMOLOGIST
 NEUROLOGIST
 RADIOLOGIST
 GYNECOLOGIST
 PEDIATRICIAN

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 FOLLOW UP
 EVERY 2 WEEKS
 MONTHLY
 CBC COUNT WEEKLY FOR THE 1ST MONTH THEN
EVERY 2 WEEKS
 RENAL & LIVER FUNCTION MONTHLY

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 MEDICATIONS
 CURRENTLY MEDICATION ACT PRIMARILY
AGAINST TACHYZOITES, NOT ERADICATING
BRADYZOITE
 PYRIMETHAMINE IS THE MOST EFFECTIVE AGENT
 LEUCOVORIN (FOLINIC ACID) SHOULD BE
ADMINISTERED CONCOMITANTLY TO PREVENT
BONE MARROW SUPPRESSION
 2ND DRUG: SULFADIAZINE & CLINDAMYCIN
SHOULD BE ADDED

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 PREVENTION
 AVOID EATING RAW MEAT, UNPASTEURIZED
MILK, & UNCOOKED EGGS
 WASH HANDS AFTER TOUCHING RAW MEATS
 WEAR GLOVES WHEN GARDENING OR
HANDLING SOIL & WASH HANDS AFTERWARDS
 WASH FRUITS & VEGETABLES
 AVOID CONTACT W/ CAT – ESPECIALLY FOR
WOMEN

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