eMedicine Specialties > Pediatrics: General Medicine > Parasitology

Toxoplasmosis: Follow-up

Author: Hakan Leblebicioglu, MD, Chairman, Professor, Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Turkey
Coauthor(s): Murat Hökelek, MD, PhD, Technical Consultant of Parasitology Laboratory, Associate Professor, Department of Clinical Microbiology, Ondokuz Mayis University Medical School, Turkey; Itzhak Brook, MD, MSc, Professor, Department of Pediatrics, Georgetown University School of Medicine
Contributor Information and Disclosures

Updated: Oct 10, 2008

Follow-up

Further Inpatient Care

  • Standard precautions are recommended with toxoplasmosis.

Further Outpatient Care

  • Follow-up visits should occur every 2 weeks until the patient is stable, then monthly during therapy.
  • Obtain CBC count weekly for the first month, then every 2 weeks.
  • Perform renal and liver function tests monthly.

Deterrence/Prevention

  • Preventing the infection is particularly important for women who are pregnant and for patients who are seronegative and immunocompromised.6
    • Avoid consuming raw or undercooked meat, unpasteurized milk, and uncooked eggs.
    • Wash hands after touching raw meat and after gardening or having other contact with soil.
    • Wash fruits and vegetables.
    • Avoid contact with cat feces.
    • To attempt to prevent congenital toxoplasmosis, routine serologic screening of pregnant women has been performed in order to identify fetuses at risk of becoming infected.
  • When feasible, avoid transfusions of blood products from a donor who is seropositive to a patient who is seronegative and immunocompromised.
  • If possible, recipients who are seronegative should receive transplanted organs from donors who are seronegative.

Complications

  • Seizure disorder or focal neurologic deficits may occur in CNS toxoplasmosis.
  • Partial or complete blindness may occur with ocular toxoplasmosis.
  • Multiple complications may occur with congenital toxoplasmosis, including mental retardation, seizures, deafness, and blindness.

Prognosis

  • Relapse often occurs in patients with immunocompromise if treatment is stopped.
  • Treatment may prevent the development of untoward sequelae in both symptomatic and asymptomatic infants with congenital toxoplasmosis.

Patient Education

  • Mothers who are infected must be completely informed of potential consequences to their fetus.
  • Explain prevention methods, such as protecting children's play areas from cat litter.
  • For excellent patient education resources, visit eMedicine's Brain and Nervous System Center. Also, see eMedicine's patient education article Brain Infection.

Miscellaneous

Medicolegal Pitfalls

  • Misdiagnosis is possible.
 


More on Toxoplasmosis

Overview: Toxoplasmosis
Differential Diagnoses & Workup: Toxoplasmosis
Treatment & Medication: Toxoplasmosis
Follow-up: Toxoplasmosis
Multimedia: Toxoplasmosis
References
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References

  1. Hill DE, Chirukandoth S, Dubey JP. Biology and epidemiology of Toxoplasma gondii in man and animals. Anim Health Res Rev. Jun 2005;6(1):41-61. [Medline].

  2. Ferguson W, Mayne PD, Lennon B, Butler K, Cafferkey M. Susceptibility of pregnant women to toxoplasma infection--potential benefits for newborn screening. Ir Med J. Jul-Aug 2008;101(7):220-1. [Medline].

  3. Trikha I, Wig N. Management of toxoplasmosis in AIDS. Indian J Med Sci. 2001;55:87-98. [Medline].

  4. Jones JL, Lopez A, Wilson M, et al. Congenital toxoplasmosis: a review. Obstet Gynecol Surv. 2001;56:296-305. [Medline].

  5. Bonfioli AA, Orefice F. Toxoplasmosis. Semin Ophthalmol. Jul-Sep 2005;20(3):129-41. [Medline].

  6. Foulon W, Naessens A, Ho-Yen D. Prevention of congenital toxoplasmosis. J Perinat Med. 2000;28:337-45. [Medline].

  7. Beaman MH. Toxoplasmosis. In: Rakel, ed. Conn's Current Therapy. 53rd ed. Philadelphia, PA: WB Saunders; 2001:156-62.

  8. Boyer KM. Diagnostic testing for congenital toxoplasmosis. Pediatr Infect Dis J. 2001;20:59-60. [Medline].

  9. Darde ML. Toxoplasma gondii, "new" genotypes and virulence. Parasite. Sep 2008;15(3):366-71. [Medline].

  10. Gardner WG. Toxoplasmosis. In: Dambro MR, ed. Griffith's 5-Minute Clinical Consult. Philadelphia, PA: Lippincott Williams & Wilkins; 1999:1090-1.

  11. McLeod R, Boyer K, Roizen N, et al. The child with congenital toxoplasmosis. Curr Clin Top Infect Dis. 2000;20:189-208. [Medline].

  12. Montoya JG, Rosso F. Diagnosis and management of toxoplasmosis. Clin Perinatol. Sep 2005;32(3):705-26. [Medline].

  13. Peyron F, Wallon M. Options for the pharmacotherapy of toxoplasmosis during pregnancy. Expert Opin Pharmacother. 2001;2:1269-74. [Medline].

  14. Pinon JM, Dumon H, Chemla C, et al. Strategy for diagnosis of congenital toxoplasmosis: evaluation of methods comparing mothers and newborns and standard methods for postnatal detection of immunoglobulin G, M, and A antibodies. J Clin Microbiol. 2001;39:2267-71. [Medline].

  15. Remington JS, Mc Leod R, Thulliez P. Toxoplasmosis. In: Remington JS and Klein JO,eds. Infectious Diseases of the Fetus and Newborn. 2001:205-346.

  16. Robert-Gangneux F. Contribution of new techniques for the diagnosis of congenital toxoplasmosis. Clin Lab. 2001;47:135-41. [Medline].

  17. Schwartzman JD. Toxoplasmosis. Curr Infect Dis Rep. 2001;3:85-89. [Medline].

  18. Tenter AM, Heckeroth AR, Weiss LM, et al. Toxoplasma gondii: from animals to humans. Int J Parasitol. 2000;30:1217-58. [Medline].

  19. Tierney LM Jr, McPhee SJ, Papadakis MA. Toxoplasmosis. In: Current Medical Diagnosis & Treatment. 40th ed. McGraw Hill; 2001:1444-7.

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Further Reading

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Keywords

toxoplasmosis, Toxoplasma gondii, congenital toxoplasmosis, congenital infection, bradyzoites, sporozoites, tachyzoites, chorioretinitis, Sabin-Feldman dye test, acquired immunodeficiency syndrome, AIDS, cerebral calcification, hydrocephalus, lymphadenopathy, myalgia, intrauterine growth retardation, jaundice, splenomegaly, nystagmus, papillitis

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Contributor Information and Disclosures

Author

Hakan Leblebicioglu, MD, Chairman, Professor, Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University Medical School, Turkey
Hakan Leblebicioglu, MD is a member of the following medical societies: American Society for Microbiology
Disclosure: Nothing to disclose.

Coauthor(s)

Murat Hökelek, MD, PhD, Technical Consultant of Parasitology Laboratory, Associate Professor, Department of Clinical Microbiology, Ondokuz Mayis University Medical School, Turkey
Murat Hökelek, MD, PhD is a member of the following medical societies: Turkish Society for Parasitology
Disclosure: Nothing to disclose.

Itzhak Brook, MD, MSc, Professor, Department of Pediatrics, Georgetown University School of Medicine
Itzhak Brook, MD, MSc is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians-American Society of Internal Medicine, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, Armed Forces Infectious Diseases Society, Association of Military Surgeons of the US, Infectious Diseases Society of America, International Immunocompromised Host Society, International Society for Infectious Diseases, Medical Society of the District of Columbia, New York Academy of Sciences, Pediatric Infectious Diseases Society, Society for Ear, Nose and Throat Advances in Children, Society for Experimental Biology and Medicine, Society for Pediatric Research, Southern Medical Association, and Surgical Infection Society
Disclosure: Nothing to disclose.

Medical Editor

Robert W Tolan Jr, MD, Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine
Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility
Disclosure: GlaxoSmithKline Honoraria Speaking and teaching; MedImmune Honoraria Consulting; MedImmune Honoraria Speaking and teaching; Merck Honoraria Speaking and teaching; Novartis Honoraria Speaking and teaching; sanofi pasteur Grant/research funds Unrestricted research grant; sanofi pasteur  Consulting; sanofi pasteur Honoraria Speaking and teaching; Tap Honoraria Speaking and teaching

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Leslie L Barton, MD, Professor, Program Director, Department of Pediatrics, University of Arizona School of Medicine
Leslie L Barton, MD is a member of the following medical societies: American Academy of Pediatrics, Association of Pediatric Program Directors, Infectious Diseases Society of America, and Pediatric Infectious Diseases Society
Disclosure: Nothing to disclose.

CME Editor

Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine
Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine
Disclosure: Baxter Honoraria Consulting; Pfizer Honoraria Consulting

Chief Editor

Russell W Steele, MD, Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine
Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association
Disclosure: None None None

 
 
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