eMedicine Specialties > Infectious Diseases > Parasitic Infections

Toxoplasmosis: Follow-up

Author: Murat Hökelek, MD, PhD, Technical Consultant of Parasitology Laboratory, Associate Professor, Department of Clinical Microbiology, Ondokuz Mayis University Medical School, Turkey
Contributor Information and Disclosures

Updated: Jan 27, 2009

Follow-up

Further Inpatient Care

  • Standard precautions are recommended in patients with toxoplasmosis.

Further Outpatient Care

  • Follow-up visits should be scheduled every 2 weeks until the patient is stable, then monthly during therapy.
  • A CBC count should be performed weekly for first month, then every 2 weeks.
  • Renal and liver function tests should be performed monthly.

Deterrence/Prevention

  • Preventing toxoplasmosis is particularly important in seronegative immunocompromised patients and in pregnant women.
    • Avoid eating raw meat, unpasteurized milk, and uncooked eggs.
    • Wash hands after touching raw meat and after gardening or handling 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 infection.
  • Avoiding transfusions of blood products from a donor who is seropositive to a patient who is seronegative and immunocompromised is prudent, when feasible.
  • If possible, recipients who are seronegative should receive transplanted organs from donors who are seronegative.
  • Laboratorians can become infected via ingestion of sporulated T gondii oocysts from feline fecal specimens or via skin or mucosal contact with either tachyzoites or bradyzoites in human or animal tissue or culture. Laboratories should have established protocols for handling specimens that contain viable T gondii and for responding to laboratory accidents.

Complications

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

Prognosis

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

Patient Education

  • Mothers with toxoplasmosis must be completely informed of potential consequences to the fetus.
  • Explain prevention methods, eg, protecting children's play area 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 of toxoplasmosis is possible.
 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous coauthor Amar Safdar, MD, FACP, FIDSA, to the development and writing of this article.



More on Toxoplasmosis

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

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Keywords

toxoplasmosis, Toxoplasma gondii, T gondii, Toxoplasma infection, congenital toxoplasmosis, systemic toxoplasmosis, febrile toxoplasmosis, lymphadenopathic toxoplasmosis, pediatric toxoplasmosis, ocular toxoplasmosis, pulmonary toxoplasmosis, extrapulmonary toxoplasmosis, toxoplasmic pneumonitis, toxoplasmic chorioretinitis, Sabin-Feldman dye test, unilateral microphthalmia, tachyzoites, bradyzoites, pneumonitis, myocarditis, necrotizing encephalitis, brain abscess, toxoplasmic encephalitis, TE, diffuse toxoplasmic encephalitis, Toxoplasma encephalitis, cerebral toxoplasmosis, CNS toxoplasmosis

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Contributor Information and Disclosures

Author

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.

Medical Editor

Douglas A Drevets, MD, Assistant Professor, Department of Medicine, Section of Infectious Disease, Oklahoma University Health Sciences Center
Douglas A Drevets, MD is a member of the following medical societies: American Association of Immunologists, American Society for Microbiology, Central Society for Clinical Research, and Christian Medical & Dental Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

John L Brusch, MD, FACP, Assistant Professor of Medicine, Harvard Medical School; Consulting Staff, Department of Medicine and Infectious Disease Service, Cambridge Health Alliance
John L Brusch, MD, FACP is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

CME Editor

Eleftherios Mylonakis, MD, Clinical and Research Fellow, Department of Internal Medicine, Division of Infectious Diseases, Massachusetts General Hospital
Eleftherios Mylonakis, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, American Society for Microbiology, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

Chief Editor

Burke A Cunha, MD, Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital
Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, and Infectious Diseases Society of America
Disclosure: Nothing to disclose.

 
 
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