Presentation
Ocular presentation Symptoms Floaters Blurring or loss of vision Sign (The hallmarks) necrotizing retinochoroiditis Satellite lesion adjacent to old hyperpigmented scars Vitreous inflammation Anterior uveitis Retinal vasculitis is also present [slideshare.net]
One patient with chronic lymphocytic leukaemia presented with severe posterior uveitis and total retinal detachment. Finally, the third patient presented with severe retinitis adjacent to the optic nerve and vitritis causing acute vision loss. [ncbi.nlm.nih.gov]
[…] of ocular toxoplasmosis based on the presentation of exudative retinal detachment, choroidal ischemia, and the absence of vitritis. [meajo.org]
We report the clinical presentation and management of three such patients. Case 1 A 15-year-old male patient presented with sudden onset blurring of vision in his right eye for 2 days and in the left eye for 2 years. [joii-journal.springeropen.com]
Entire Body System
- Epilepsy
Medical history included epilepsy at age 14 and mild mental retardation. Iridocyclitis and vitreous opacity were observed in the right eye, and furthermore widespread retinal vessel sheathing due to frosted branch angiitis was seen. [ncbi.nlm.nih.gov]
Symptoms of toxoplasmosis in babies can include: hydrocephalus - water on the brain brain damage epilepsy - a condition that affects the brain and causes repeated seizures (fits) jaundice - yellowing of the skin and the whites of the eyes deafness eye [your.md]
Immune System
- Generalized Lymphadenopathy
Lymph node: isolated, multiple or generalized lymphadenopathy. Heart: myocarditis, in the severely immunocompromised. Lung: pneumonitis, in HSCT recipients. [hopkinsguides.com]
Respiratoric
- Pharyngitis
2-day test serum *More Info Actinobacillus pleuropneumoniae - APP Porcine CF Serotype 3 $5.00 $4.50 W 2-day test serum *More Info Actinobacillus suis Porcine PCR $30.00 $27.00 M, Th next day lung, bronchial swab, culture, laryngeal swab, oral fluid, pharyngeal [vetmed.iastate.edu]
A few of these also have a mild flu-like syndrome of fever, malaise, myalgia, hepatosplenomegaly, and less commonly, pharyngitis, which can mimic infectious mononucleosis and include lymphadenitis. [merckmanuals.com]
Gastrointestinal
- Overeating
We report on five women and one man (aged 33-64 years old; median 44.6 years) who developed FHC over a period of time ranging from 2-13 years. [ncbi.nlm.nih.gov]
Cardiovascular
- Hypertension
The ophthalmological examination revealed hypertensive non-granulomatous panuveitis, retinal vasculitis with focus of retinochoroiditis with pigmented central area suggestive of ocular toxoplasmosis in the active phase. [ncbi.nlm.nih.gov]
Other common clinical features of ocular toxoplasmosis include: Satellite lesion next to an inactive retinochoroidal scar Retinochoroidal scar Focal or widespread vasculitis Inflammatory ocular hypertension syndrome [mdmag.com]
Inflammatory ocular hypertension 10% to 15% of cases [8,31,55]. [eyewiki.aao.org]
Other common clinical signs of ocular toxoplasmosis include satellite lesion (adjacent to an inactive retinochoroidal scar as seen in fig. 4 ), retinochoroidal scar, focal or widespread vasculitis, and inflammatory ocular hypertension syndrome [ 38 ]. [karger.com]
Musculoskeletal
- Small Head
Babies infected late in pregnancy rarely miscarry but instead have symptoms such as: seizures brain damage enlarged spleen and liver inflammation of the eye jaundice (yellowing of the skin and whites of eyes) poor motor coordination unusually small head [medbroadcast.com]
Toxoplasmosis. toxoplasmosis, neonatal, n an infection passed to the fetus during pregnancy via the placenta that can cause mental retardation, blindness, or an abnormally small head. [medical-dictionary.thefreedictionary.com]
Eyes
- Retinal Lesion
We describe a patient with ocular hypertension and nonglaucomatous retinal nerve fiber layer (RNFL) atrophy associated with an ocular toxoplasmosis retinal lesion. Single case report. [ncbi.nlm.nih.gov]
At 20 weeks of follow up — c Color fundus picture shows healed, pigmented, and scarred lesion infero-temporal to fovea and d OCT scan over the lesion shows reduced retinal thickness, distorted architecture of retinal layers temporal to the fovea, reduced [joii-journal.springeropen.com]
- Visual Impairment
CONCLUSIONS: In this study, visual impairment in majority of the patients was found to be related to vitreous cells and flare. [ncbi.nlm.nih.gov]
At the first consultation, 61.7 % of the affected eyes had visual impairment (VA<0.3). Visual impairment was associated with macular lesions (P<0.001, OR=3 [1.4-6.1]) and age greater than 45 years (P=0.002, OR=11 [2.2-53.6]). [pesquisa.bvsalud.org]
It is also a leading cause of visual impairment throughout the whole world, accounting for up to 57% of visual impairment and 24% of blindness in infected persons [ 2, 3 ]. [omicsonline.org]
- Blurred Vision
Suddenly blurred vision, floater, and pain could be caused by Toxoplasma gondii. Flashing, may necessitate a more precise peripheral fundus examination. [ncbi.nlm.nih.gov]
Box. 7191, Riyadh - 11462 Saudi Arabia Source of Support: None, Conflict of Interest: None DOI: 10.4103/0974-9233.164624 Abstract A 24-year-old healthy male presented with a chief complaint of blurred vision in the right eye for 1-week. [meajo.org]
- Photophobia
A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye. [ncbi.nlm.nih.gov]
Case summary: A 48-year-old man presented with a 1-week history of red eye, photophobia, eyeball pain, and decreased visual acuity of the left eye. Best corrected visual acuity was 20/200 in the left eye and 20/20 in the right eye. [evrs.eu]
Symptoms of ocular disease include Eye pain Sensitivity to light (photophobia) Tearing of the eyes Blurred vision The eye disease can reactivate months or years later, each time causing more damage to the retina. [cdc.gov]
Photophobia and a general hyperesthesia to all forms of stimuli are present. Venous congestion of the ocular fundi is common. [atsu.edu]
Other complaints included photophobia, ocular pain, floaters and redness were comparable to presenting complaints seen in Kaduna, Nigeria, where reduced vision was the most common presenting complaint followed by photophobia, pain, irritation, redness [jovr.org]
- Retinal Pigmentation
Human retinal pigment epithelial (RPE) cells (ARPE-19) were infected in vitro with T. gondii and collected after 60, 120, 240 min, and 24 h. [ncbi.nlm.nih.gov]
Optical coherence tomography (OCT) revealed left optic disc swelling, cysoid macular edema, and retinal pigment epithelial atrophy. Pupillary light reflex and color vision were normal. [evrs.eu]
Contd In Immunosuppressed Have both tachyzoites and tissue cysts in areas of retinal necrosis and within retinal pigment epithelial cells. Parasites can occasionally be found in the iris, choroid, vitreous, and optic nerve 10. [slideshare.net]
Using either route, parasites were observed in the retinal vessel with the formation of a glial reaction in the inner plexiforme layer and discontinuity of the pigmented epithelium of the retina 7 days after infection. [cambridge.org]
Psychiatrical
- Aggressive Behavior
Effects of inhaled Linalool in anxiety, social interaction and aggressive behavior in mice. Phytomedicine 17, 679–683. doi: 10.1016/j.phymed.2009.10.002 PubMed Abstract | CrossRef Full Text | Google Scholar Lovering, A. L., Safadi, S. [frontiersin.org]
Neurologic
- Seizure
He did not give a history of ocular trauma, redness or pain in that eye, seizures or any treatment in the past. He is a non-vegetarian. There is no history of contact with cats. [mjdrdypu.org]
For example, a person who is HIV-infected and who has reactivated Toxoplasma infection can have symptoms that include fever, confusion, headache, seizures, nausea, and poor coordination. [cdc.gov]
These patients typically have headache, altered mental status, seizures, coma, fever, and sometimes focal neurologic deficits, such as motor or sensory loss, cranial nerve palsies, visual abnormalities, and focal seizures. [merckmanuals.com]
Symptoms can include: coma loss of vision or other senses partial paralysis weakness tremors headache confusion difficulty speaking seizures fever For the majority of people with AIDS who have toxoplasmosis, the onset of symptoms is quite slow and subtle [medbroadcast.com]
Seizures. Heart disorders. Yellowing of the skin and whites of the eyes, also called jaundice. Rash. Most babies with toxoplasmosis do not show symptoms. But problems may show up later in childhood or teenage years. [mayoclinic.org]
- Cerebral Calcification
calcifications and convulsions; (2) atypical encephalitis; (3) postencephalitic sequelae, or (4) pneumonitis associated with fever and a rash. [jamanetwork.com]
The congenital form may be asymptomatic or may produce encephalomyelitis with cerebral calcification, chorioretinitis and blindness, and even death. [medical-dictionary.thefreedictionary.com]
Disease in neonates may be severe, particularly if acquired early in pregnancy; symptoms include jaundice, rash, hepatosplenomegaly, and the characteristic tetrad of abnormalities: Bilateral retinochoroiditis Cerebral calcifications Hydrocephalus or microcephaly [merckmanuals.com]
calcifications and chorioretinitis, leading to encephalopathy and possibly blindness.[6] If a woman receives her first exposure to T. gondii while pregnant, the fetus is at particular risk.[6] A simple blood draw at the first prenatal doctor visit can [en.wikipedia.org]
- Convulsions
[…] a chronic latent stage. 2 In human beings the following clinical forms have been recognized, characterized chiefly by (1) congenital or neonatal meningoencephalitis, usually associated with hydrocephaly, chorioretinitis, cerebral calcifications and convulsions [jamanetwork.com]
The congenital form is characterized by liver and brain involvement with cerebral calcification, convulsions, blindness, microcephaly or hydrocephaly, and mental retardation. [medical-dictionary.thefreedictionary.com]
Meningitis may be localized for a time to one hemisphere or the other, cause jacksonian convulsions, hemiparesis, or even hemianopia. Infants with meningitis offer the greatest diagnostic problem because the manifestations are nonspecific. [atsu.edu]
Serologically confirmed DENV infection with PRES in a 44-year-old woman who presented with an occipital headache and a convulsive crisis. [pubs.rsna.org]
Workup
They usually resolve after 6 weeks. [21] Workup Fluorescein angiography Fluorescein angiography (FA) of active lesions shows hypofluorescence during the early phase of the study, followed by progressive hyperfluorescence secondary to leakage. [emedicine.medscape.com]
Imaging is paramount not only to detect but also to characterize CNS disease, and ultimately to guide decision making on further diagnostic workup or therapeutic management. [pubs.rsna.org]
The patient was admitted to the hospital for a sepsis workup. On examination, she was not in acute distress; her vital signs were normal. Her neck was supple. No skin wounds, cellulitis, abscesses, joint arthritis or cardiac murmurs were noticed. [karger.com]
Microbiology
- Toxoplasma Gondii
This work was aimed at better understanding the impact of genotypes of Toxoplasma gondii strains on toxoplasmic retinochoroiditis. [ncbi.nlm.nih.gov]
Prevalence of Toxoplasma gondii infection in Myocastor coypus in a protected Italian wetland. Parasit Vectors. 2011;4:240. Zhou P, Chen Z, Li H-L, Zheng H, He S, Lin R-Q, et al. Toxoplasma gondii infection in humans in China. [ijpa.tums.ac.ir]
Treatment
Treatment and Prevention Available drugs do not eliminate tissue cysts and cannot prevent chronic infection No treatment has proven to be superior or even more effective than no treatment Antitoxoplasmic agents and systemic steroids have never been [slideshare.net]
Depot steroid therapy is absolutely contraindicated in the treatment of ocular toxoplasmosis. [emedicine.medscape.com]
A review of treatment based on this pathology is briefly discussed. [ncbi.nlm.nih.gov]
Prognosis
To report the clinical course and prognosis of retinal breaks and detachments occurring in patients with ocular toxoplasmosis. [ncbi.nlm.nih.gov]
Prognosis The prognosis is poor when congenital toxoplasmosis is acquired during the first three months of pregnancy. [medical-dictionary.thefreedictionary.com]
Prognosis Retinochoroiditis is the most frequent manifestation of congenital toxoplasmosis. [eyewiki.aao.org]
Long-term ocular prognosis in 327 children with congenital toxoplasmosis. [scielo.br]
Etiology
The possibility of retinal ischemia or inflammation alone as an etiology are discussed. A 19 year old woman developed optic nerve edema and a marked decrease in vision associated with a nasal toxoplasma lesion and a macular star. [ncbi.nlm.nih.gov]
Presentation History The history may suggest an etiology and may reveal clues concerning the likelihood of an infectious etiology. [emedicine.medscape.com]
In a study by Nguyen et al. [ 17 ], toxoplasmosis was the most common etiology of uveitis in patients referred to a tertiary center and had a prevalence of 14% among all other etiologies. [karger.com]
Epidemiology
Considering the local epidemiological data, our OT patients seemed to be infected more frequently by ordinary type II strains found in the environment. [ncbi.nlm.nih.gov]
Pathophysiology
The aim of the present review was to report on the results of a survey of leading uveitis experts, in which the authors asked participants to address some of the most important issues related to diagnosis, pathophysiology, and treatment of ocular toxoplasmosis [ncbi.nlm.nih.gov]
Pathophysiology Infection with Toxoplasma gondii. Physical Examination List of classic and atypical findings which have been reported. [eyewiki.aao.org]
Prevention
Treatment and Prevention Available drugs do not eliminate tissue cysts and cannot prevent chronic infection No treatment has proven to be superior or even more effective than no treatment Antitoxoplasmic agents and systemic steroids have never been [slideshare.net]
Hence to highlight this blinding disease, which may escape detection and to emphasize its preventive measures so as to prevent the visual disability arising from it. [mjdrdypu.org]
We present 2 cases of recurrent OT in immunocompetent patients for whom prophylaxis prevented recurrence of disease. [ncbi.nlm.nih.gov]
Prevention of Recurrences Prevention of recurrences of toxoplasmic retinochoroiditis may prevent loss of vision. Patients with paramacular toxoplasmosis may be given antimicrobial prophylaxis to prevent recurrences. [aao.org]