Cases reported "Toxoplasmosis"

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1/11. A toxoplasmic uveitis case of a 60-year-old male in korea.

    A toxoplasmic uveitis case was reported on the focus of impairment of pathological findings and serological antibody titers after chemotherapy. A chief complaint of a 60-year-old male was a decreased and blurred vision in his right eye for 2 weeks after experiencing tremendous stress and fatigue. A steroid therapy for 3 weeks was not effective and the retinal lesion became necrotic. Anti-toxoplasma gondii antibody titer was checked to be a strong positive by both ELISA and indirect latex agglutination assay (ILA). He was treated with Fansidar F for 8 weeks. His vision improved as the necrotic lesion healed by scarring, but the antibody titers still remained very high without any signs of negative conversion. It is suggested to be a recurrent case of the past asymptomatic infection by presumed immune suppression caused by excessive stress.
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2/11. Necrotizing lymphadenitis: possible acute toxoplasmic infection.

    A rapid rise in serum hemagglutination antibody (HA) titers for toxoplasma was detected about 2 months after the onset of cervical lymphadenopathy in two patients with necrotizing lymphadenitis. These lymph nodes proliferation of histiocytes with nuclear debris, phagocytized macrophages and necrotic areas, and the association suggested that necrotizing lymphadenitis might be caused by acute toxoplasmic infection.
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3/11. High levels of IgM antibodies specific for toxoplasma gondii in pregnancy 12 years after primary toxoplasma infection. Case report.

    A case of high levels of specific IgM antibodies registered by the immunosorbent agglutination assay (ISAgA) in a pregnant woman with a history of toxoplasmosis is reported. The patient had acute lymphoglandular toxoplasmosis diagnosed serologically by increases in the specific antibody titer detected by the Sabin-Feldman test (SFT) and pathohistologically 12 years before pregnancy. In pregnancy, she had stable titers of specific antibodies registered by the SFT, enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibody test (IFAT), indirect hemagglutination test (IHAT) and direct agglutination test. Specific IgM antibodies were detected by the ISAgA but not by the IgM-IFAT, IgM-ELISA and IgM-IHAT. She had a normal pregnancy and gave birth to a clinically healthy baby who had a negative ISAgA finding at 7 days of age. This case indicates that ISAgA is not necessarily a marker of recent infection and is therefore not reliable for the diagnosis of toxoplasmosis in pregnancy.
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4/11. New methods in the diagnosis and management of cerebral toxoplasmosis associated with the acquired immune deficiency syndrome.

    Cerebral toxoplasmosis is a life-threatening condition associated with the acquired immune deficiency syndrome (AIDS). Current diagnostic and therapeutic methods have serious limitations. The diagnosis of cerebral toxoplasma infection in a patient with AIDS was assisted by the detection of specific IgM in a highly sensitive immunosorbent agglutination assay and by the demonstration of toxoplasma gondii nucleic acid in a brain biopsy specimen by means of the polymerase chain reaction. Following initial failure of the patient to respond to treatment with sulphadiazine and pyrimethamine, clinical improvement was observed during treatment with clindamycin followed by dapsone. Further assessment of novel methods in the management of cerebral toxoplasmosis is required.
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5/11. Comparison of different serotests for specific toxoplasma IgM-antibodies (ISAGA, SPIHA, IFAT) and detection of circulating antigen in two cases of laboratory acquired toxoplasma infection.

    Two symptomatic toxoplasma infections of laboratory personnel have been serologically followed up for 5.5 and 10 months, respectively. Results obtained by commonly used test systems (indirect fluorescent antibody tests for IgG and IgM antibodies, complement fixation test) were compared with those of two recently developed and improved tests for IgM detection (immunosorbent agglutination assay [ISAGA] and solid-phase indirect haemadsorption assay [SPIHA] as well as with those of a test designed for the detection of circulating antigen (cag-ELISA).
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6/11. incidence of toxoplasmosis in pregnant women in the city of Malmo, sweden.

    The incidences of latent and primary toxoplasma gondii infections in pregnant women were studied using stored sera from 4,351 women delivered in the city of Malmo, sweden in 1982 and 1983. Infants born to mothers with signs of primary infection (seroconversion or specific IgM in sera collected during pregnancy) were studied with regard to serological evidence of congenital infection (specific IgM in cord serum). Sera were tested for specific IgG antibodies by direct agglutination test and enzyme-linked immunosorbent assay, and for specific IgM by immunosorbent assay. 40% of the women were seropositive at delivery. Seroconversion (change from negative to positive serological status) was demonstrated in 12 pregnant women and specific IgM in the first postconceptional serum sample (indicating infection in the first trimester or in the last year(s) before conception) in another 17. The incidence of primary maternal infection was calculated to 4-6:1,000 deliveries. Among the 29 infants born to mothers with seroconversion or, alternatively, IgM in the first postconceptional sample, 6 had laboratory signs of congenital infection. One of the 6 had a positive toxoplasma isolation test in autopsy material and 5 had a clearly positive IgM value in cord serum. The real incidence of congenital infection in this material is unknown since IgM might be absent or sparse in cord serum in spite of congenital infection. The noticeable prevalence of maternal toxoplasmosis in Malmo calls for further incidence studies in sweden.
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7/11. toxoplasma gondii and the compromised host. Antibody response in the absence of clinical manifestations of disease.

    toxoplasmosis is a well-described opportunistic infection in immunocompromised hosts. meningoencephalitis, myocarditis, and pneumonitis are the most frequent clinical manifestations of disease. Because of difficulties both with isolation of the organism and with its identification in tissue, most laboratories rely on serological techniques for diagnosis of acute disease. The most widely available and commonly employed serological method is the indirect fluorescent antibody test (IFA). We recently encountered an immunocompromised patient with an undefined hematologic malignant neoplasm who had an IFA titer greater than 1:100,000 without clinical evidence of active toxoplasmosis. Although his dye test titer and direct agglutination titer were also elevated, he had negative double-sandwich-IgM enzyme-linked immunosorbent assay titers. Immunoperoxidase staining of the tissues failed to demonstrate trophozoites. This case demonstrates that elevated toxoplasma IFA titers may occur in patients at high risk for opportunistic infection but who do not manifest overt clinical toxoplasmosis.
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8/11. polymyositis and toxoplasmosis.

    Extensive severe polymyositis in a patient with toxoplasmosis was presented. toxoplasmosis was serologically substantiated by a serial two tube rise in a toxoplasma-antibody titer by a hemagglutination test. When appeared to be toxoplasma gondii was detected in areas of myositis. toxoplasma gondii was found in a single small area of hepatic necrosis, but no other organ or tissue was involved. Thus, the present case was peculiar in respect that skeletal muscles were the major target of toxoplasmosis. A causal relationship between toxoplasmosis and polymyositis was discussed and the literatures were reviewed. Serological investigation and histopathological search for toxoplasma gondii should be done in every case of polymyositis not only for the appropriate therapy but also for the further elucidation of the relationship between toxoplasmosis and polymyositis.
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9/11. recurrence of acute colonic pseudo-obstruction in selective adrenergic dysautonomia associated with infectious toxoplasmosis.

    BACKGROUND: Acute colonic pseudo-obstruction is a life-threatening condition associated with several pathologic conditions, whose pathophysiology is still uncertain. CASE: Autonomic function in a young patient operated on for acute colonic pseudo-obstruction was carefully evaluated; none of the common clinical conditions described in the literature was found to have caused the syndrome. Selective adrenergic failure was suggested by the presence of severe orthostatic hypotension, low basal plasma catecholamine level, and absence of the expected increase on standing and by the findings of provocation tests, cardiovascular tests, and acetylcholine sweat spot test. biopsy specimens from the colon and small-bowel wall did not show any morphologic or immunohistochemical alteration either in muscle layers or in the autonomic plexus, testifying to the possible occurrence of extrinsic denervation in the presence of an intact plexus. Infectious toxoplasmosis was proved through indirect and direct hemagglutination assays, enzyme-linked immunosorbent assay IgG, IgM, and IgA, immunosorbent agglutination IgM assay, and the protozoa were demonstrated in a biopsy specimen from the rectus abdominis muscle. CONCLUSIONS: Selective adrenergic denervation of the gut resulted in recurrent episodes of colonic pseudo-obstruction, probably by direct toxicity or a cross-reaction between the immune process and a toxoplasmic antigen, stressing the importance of sympathetic inhibitory modulation on colon motor activity.
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10/11. Foodborne outbreaks of human toxoplasmosis.

    Two outbreaks of acute toxoplasmosis involving 8 adult patients in korea were linked to eating uncooked pork. In the first outbreak, 3 patients developed unilateral chorioretinitis within 3 months of eating a meal consisting of raw spleen and liver of a wild pig. In the second outbreak, 5 of 11 soldiers who ate a meal consisting of raw liver of a domestic pig developed lymphadenopathy. All 8 patients had high levels of IgG toxoplasma gondii antibodies (> or = 1:1024) in the Sabin-Feldman dye test, modified agglutination test incorporating mercaptoethanol, and latex agglutination test. T. gondii IgM antibodies persisted in these patients for several months. Most patients had a favorable response to anti-T. gondii chemotherapy with pyrimethamine and sulfanomides.
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