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Bolais PF, Galal L, Cronemberger C, Pereira FDA, Barbosa ADS, Dib LV, Amendoeira MRR, Dardé ML, Mercier A. Toxoplasma gondii in the faeces of wild felids from the Atlantic Forest, Brazil. Mem Inst Oswaldo Cruz 2022; 117:e210302. [PMID: 35766781 PMCID: PMC9241165 DOI: 10.1590/0074-02760210302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/28/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Toxoplasma gondii is a apicomplexan parasite of virtually all warm-blooded species. All true cats (Felidae) can act as definitive hosts for this parasite by shedding resistant oocysts into the environment. However, the patterns of oocysts shedding are only partially understood in domestic cats and largely unknown in wild felids. OBJECTIVES We carried out molecular analysis of 82 faecal samples from wild felids collected in the Serra dos Órgãos National Park (Parnaso), Rio de Janeiro, Brazil. METHODS We screened samples for T. gondii DNA using a quantitative polymerase chain reaction (qPCR) targeting the 529bp DNA fragment. Polymerase chain reaction (PCR)-positive samples were genotyped using 15 microsatellite markers. RESULTS Only one faecal sample from a Puma yagouaroundi was PCR-positive [cycle threshold (Ct) = 26.88]. This sample was contaminated by a T. gondii strain of BrIII lineage, a common lineage in domestic animals from Brazil. MAIN CONCLUSIONS This first report of T. gondii in faeces of wild South American felids in their natural environment indicates infrequent oocyst shedding and suggests a role of acquired immunity in limiting re-excretion as in domestic cats. The presence of a domestic strain of T. gondii in a faecal sample from a wild felid at very low concentrations (not detected by microscopy) is consistent with the hypothesis of host-parasite co-adaptations limiting the circulation of T. gondii strains between domestic and wild environments.
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Affiliation(s)
- Paula F Bolais
- University of Limoges, Institute of Epidemiology and Tropical Neurology, Epidemiology of Chronic Diseases in Tropical Zone, OmegaHealth, Limoges, France
| | - Lokman Galal
- University of Limoges, Institute of Epidemiology and Tropical Neurology, Epidemiology of Chronic Diseases in Tropical Zone, OmegaHealth, Limoges, France
| | - Cecília Cronemberger
- Instituto Chico Mendes de Conservação da Biodiversidade, Parque Nacional da Serra dos Órgãos, Teresópolis, RJ, Brasil
| | - Fabiane de Aguiar Pereira
- Instituto Chico Mendes de Conservação da Biodiversidade, Parque Nacional da Serra dos Órgãos, Teresópolis, RJ, Brasil
| | - Alynne da Silva Barbosa
- Universidade Federal Fluminense, Instituto Biomédico, Departamento de Microbiologia e Parasitologia, Niterói, RJ, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Toxoplasmose e Outras Protozooses, Rio de Janeiro, RJ, Brasil
| | - Laís Verdan Dib
- Universidade Federal Fluminense, Instituto Biomédico, Departamento de Microbiologia e Parasitologia, Niterói, RJ, Brasil.,Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Toxoplasmose e Outras Protozooses, Rio de Janeiro, RJ, Brasil
| | - Maria Regina Reis Amendoeira
- Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Laboratório de Toxoplasmose e Outras Protozooses, Rio de Janeiro, RJ, Brasil
| | - Marie-Laure Dardé
- University of Limoges, Institute of Epidemiology and Tropical Neurology, Epidemiology of Chronic Diseases in Tropical Zone, OmegaHealth, Limoges, France.,Centre Hospitalier-Universitaire Dupuytren, Centre National de Référence, Toxoplasmose/Toxoplasma Biological Centre, Limoges, France
| | - Aurélien Mercier
- University of Limoges, Institute of Epidemiology and Tropical Neurology, Epidemiology of Chronic Diseases in Tropical Zone, OmegaHealth, Limoges, France.,Centre Hospitalier-Universitaire Dupuytren, Centre National de Référence, Toxoplasmose/Toxoplasma Biological Centre, Limoges, France
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Casartelli-Alves L, Pereira SA, Ferreira LC, de Macedo Couto R, Schubach TMP, Amendoeira MRR, da Silva RC, Langoni H, Millar PR, Menezes RC. Genetic and histopathological characterization of Toxoplasma gondii genotypes isolated from free-range chickens reared in the metropolitan region of Rio de Janeiro state, Brazil. Parasitol Res 2021; 120:665-677. [PMID: 33415402 DOI: 10.1007/s00436-020-07011-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/07/2020] [Indexed: 11/30/2022]
Abstract
This study aimed to genetically characterize Toxoplasma gondii isolates obtained from free-range chickens reared in the metropolitan region of the state of Rio de Janeiro, Brazil, and to evaluate the morbidity and histological changes associated with these isolates in mice. A mouse bioassay was used to isolate T. gondii from a pool of tissue samples (brain, heart, and thigh muscles) collected from 163 chickens. The 36 isolates obtained were genetically characterized by restriction fragment polymorphism (PCR-RFLP) analysis of the SAG1, 5'-3'SAG2, aSAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, Apico, and CS3 genomic regions. Seventeen atypical genotypes were identified and nine of them were reported for the first time. All identified genotypes caused clinical signs and histological changes in mice, with the majority being associated with high cumulative morbidity (65%) and severe or very severe histological changes (76%). The exclusive identification of atypical genotypes, with a predominance of new genotypes, indicates great genetic diversity of T. gondii in the region studied. In addition, the finding that all identified genotypes caused clinical signs and often severe histological changes in mice suggests potentially relevant virulence of these strains.
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Affiliation(s)
- Luciana Casartelli-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Avenida Brasil, 4365, Rio de Janeiro, RJ, Brazil
| | - Sandro Antonio Pereira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Avenida Brasil, 4365, Rio de Janeiro, RJ, Brazil
| | - Luiz Cláudio Ferreira
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Avenida Brasil, 4365, Rio de Janeiro, RJ, Brazil
| | - Rodrigo de Macedo Couto
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Avenida Brasil, 4365, Rio de Janeiro, RJ, Brazil
| | - Tânia Maria Pacheco Schubach
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Avenida Brasil, 4365, Rio de Janeiro, RJ, Brazil
| | | | - Rodrigo Costa da Silva
- Faculdade de Ciências Agrárias, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Hélio Langoni
- Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, São Paulo, Brazil
| | - Patrícia Riddell Millar
- Instituto Biomédico, Universidade Federal Fluminense, Rua Prof. Hernani Pires de Melo, 101, Niterói, RJ, Brazil.
| | - Rodrigo Caldas Menezes
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz (Fiocruz), Avenida Brasil, 4365, Rio de Janeiro, RJ, Brazil
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3
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Hryzhak IH. Infection with Toxoplasma gondii can promote chronic liver diseases in HIV-infected individuals. Folia Parasitol (Praha) 2020; 67. [PMID: 33281122 DOI: 10.14411/fp.2020.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
Abstract
Liver pathologies and infection with Toxoplasma gondii (Nicolle et Manceaux, 1908) are widespread among HIV-infected patients. However, a possible contribution of toxoplasmosis to the development of various forms of liver diseases in HIV-infected individuals has not yet been determined. This research is a retrospective cohort study. Medical cards of 907 HIV-positive patients, including 119 individuals who died, were studied. The patients were divided into two groups: 531 patients were seropositive to T. gondii and 376 seronegative. General liver pathology was more widespread among patients seropositive to T. gondii than in seronegative patients (63.1 ± 2.1% and 51.9 ± 2.6%, respectively, p < 0.001). The association of seropositive to T. gondii with general liver pathology is weak both in the whole cohort (Pearson's contingency coefficient C = 0.112), and among the deceased patients (C = 0.228). Chronic HBV-HCV coinfection was more common in the seropositive than in seronegative individuals as it was found both in entire cohorts (26.0 ± 1.9% and 18.6 ± 2.0%, respectively, p = 0.010) and in died patients (31.0 ± 5.5% and 14.6 ± 5.1%, respectively, p = 0.041). Toxoplasma gondii had a weak role in distributing of HBV-HCV coinfection between cohorts (C = 0.187). In both cohorts in patients with chronic hepatitis, regardless of its etiology, there was no significant difference in alanine transaminase activity (ALT). Cirrhosis of the liver occurred 4.5 times more often in deceased seropositive patients than in the entire seropositive cohort (23.9 ± 5.1 and 5.3 ± 2.0, respectively, p = 0.0006) whereas it no significantly increased in seronegative cohort (10.4 ± 4.4 against 4.8 ± 1.1, p > 0.05). In them T. gondii is weakly involved in cirrhosis formation (C = 0.168). Thus, in HIV-infected patients, T. gondii is a weak nonspecific adjunct that supports chronic liver inflammation and progression of cirrhosis, regardless of etiology, but does not influence the degree of hepatitis activity. The increased prevalence of HBV-HCV coinfection in patients seropositive for T. gondii may be related to their risk factor behaviour associated with uncontrolled blood contacts.
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Affiliation(s)
- Ihor H Hryzhak
- Ivano-Frankivsk National Medical University (Ivano-Frankivsk, Ukraine)
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4
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Blaizot R, Nabet C, Laghoe L, Faivre B, Escotte-Binet S, Djossou F, Mosnier E, Henaff F, Blanchet D, Mercier A, Dardé ML, Villena I, Demar M. Outbreak of Amazonian Toxoplasmosis: A One Health Investigation in a Remote Amerindian Community. Front Cell Infect Microbiol 2020; 10:401. [PMID: 33042853 PMCID: PMC7516351 DOI: 10.3389/fcimb.2020.00401] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/30/2020] [Indexed: 12/16/2022] Open
Abstract
Background:Toxoplasma gondii is a parasite of worldwide importance but its burden in indigenous communities remains unclear. In French Guiana, atypical strains of T. gondii originating from a complex rainforest cycle involving wild felids have been linked to severe infections in humans. These cases of Amazonian toxoplasmosis are sporadic and outbreaks are rarely described. We report on the investigation of an outbreak of acute toxoplasmosis in a remote Amerindian village. We discuss the causes and consequences of this emergence. Methods: In May 2017, during the rainy season and following an episode of flooding, four simultaneous cases of acute toxoplasmosis were serologically confirmed in two families living the village. Other non-diagnosed cases were then actively screened by a medical team along with epidemiological investigations. Inhabitants from nine households were tested for T. gondii antibodies and parasite DNA by PCR when appropriate. Samples of water, cat feces and cat rectal swabs, soil, and meat were tested for T. gondii DNA by PCR. Positive PCR samples with sufficient DNA amounts were genotyped using 15 microsatellite markers. Results: Between early May and early July 2017, out of 54 tested inhabitants, 20 cases were serologically confirmed. A fetus infected at gestational week 10 died but other cases were mild. Four patients tested positive for parasite DNA and two identical strains belonging to an atypical genotype could be isolated from unrelated patients. While domestic cats had recently appeared in the vicinity, most families drank water from unsafe sources. Parasite DNA was recovered from one water sample and nine soil samples. Three meat samples tested positive, including wild and industrial meat. Conclusions: The emergence of toxoplasmosis in such a community living in close contact with the Amazon rainforest is probably multifactorial. Sedentary settlements have been built in the last few decades without providing safe water sources, increasing the risk of parasite circulation in cases of dangerous new habits such as cat domestication. Public health actions should be implemented in these communities such as safe water supply, health recommendations, and epidemiological surveillance of acute toxoplasmosis. A “One Health” strategy of research involving medical anthropology, veterinary medicine, and public health needs to be pursued for a better understanding of the transmission routes and the emergence of this zoonosis.
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Affiliation(s)
- Romain Blaizot
- Department of Parasitology-Mycology, Hôpital Andrée Rosemon, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, Université de Guyane, Cayenne, French Guiana
| | - Cécile Nabet
- Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Service de Parasitologie-Mycologie, Paris, France
| | - Laure Laghoe
- EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, Université de Guyane, Cayenne, French Guiana
| | - Benjamin Faivre
- Department of Pediatrics, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - Sandie Escotte-Binet
- EA 7510 ESCAPE, Université de Reims Champagne-Ardenne, SFR Cap Santé, Reims, France.,Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire de Reims, Reims, France
| | - Felix Djossou
- Department of Infectious Diseases, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - Emilie Mosnier
- Centres Délocalisés de Prévention et de Soins, Hôpital Andrée Rosemon, Cayenne, French Guiana.,INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de La Santé & Traitement de l'Information Médicale, Aix Marseille University, Marseille, France
| | - Fanny Henaff
- Department of Pediatrics, Hôpital Andrée Rosemon, Cayenne, French Guiana.,Centres Délocalisés de Prévention et de Soins, Hôpital Andrée Rosemon, Cayenne, French Guiana
| | - Denis Blanchet
- Department of Parasitology-Mycology, Hôpital Andrée Rosemon, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, Université de Guyane, Cayenne, French Guiana
| | - Aurélien Mercier
- Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France.,INSERM, Univ. Limoges, CHU Limoges, UMR 1094, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, Limoges, France
| | - Marie-Laure Dardé
- Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France.,INSERM, Univ. Limoges, CHU Limoges, UMR 1094, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, Limoges, France
| | - Isabelle Villena
- EA 7510 ESCAPE, Université de Reims Champagne-Ardenne, SFR Cap Santé, Reims, France.,Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire de Reims, Reims, France
| | - Magalie Demar
- Department of Parasitology-Mycology, Hôpital Andrée Rosemon, Cayenne, French Guiana.,EA 3593, Ecosystèmes Amazoniens et Pathologies Tropicales, Université de Guyane, Cayenne, French Guiana
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5
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Bezerra RDS, Diefenbach CF, Pereira DV, Kashima S, Slavov SN. Viral metagenomics performed in patients with acute febrile syndrome during Toxoplasma gondii outbreak in south Brazil. Braz J Infect Dis 2020; 24:250-255. [PMID: 32422120 PMCID: PMC9392116 DOI: 10.1016/j.bjid.2020.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 11/16/2022] Open
Abstract
Toxoplasmosis is a zoonotic infection caused by the protozoan parasite Toxoplasma gondii. The infection is widely disseminated in the human population and is usually benign or asymptomatic. Systemic T. gondii infection presents risks for pregnant women and AIDS patients. Although rare, T. gondii can cause outbreaks in urban centers. The origin of these outbreaks is not completely understood but probably results from introduction of zoonotic T. gondii strains in the population. During such outbreaks other pathogens which mimic T. gondii acute febrile syndrome may also circulate; therefore, detailed investigation of the outbreak is of extreme importance. In this study we performed viral metagenomics next-generation sequencing (mNGS) in patient samples obtained during T. gondii outbreak in Santa Maria city, South Brazil. Specific bioinformatics pipelines specialized in virus discovery were applied in order to identify co-circulating vial agents. Epstein Barr virus and Parvovirus B19 contigs were assembled and these viruses can cause symptoms similar to toxoplasmosis. In conclusion, our findings show the importance of Metagenomics next generation sequencing (mNGS) use to help characterize the outbreak more completely and in the management of the affected patients.
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Affiliation(s)
- Rafael Dos Santos Bezerra
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ciências Biológicas e da Saúde, Riberão Preto,SP, Brazil; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hemocentro, Ribeirão Preto, SP, Brazil
| | - Cristiane Fração Diefenbach
- Hospital De Caridade Dr. Astrogildo De Azevedo, Departamento de Hematologia e Oncologia, Rio Grande do Sul, RS, Brazil
| | - Dalnei Veiga Pereira
- Hospital De Caridade Dr. Astrogildo De Azevedo, Departamento de Hematologia e Oncologia, Rio Grande do Sul, RS, Brazil
| | - Simone Kashima
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hemocentro, Ribeirão Preto, SP, Brazil
| | - Svetoslav Nanev Slavov
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hemocentro, Ribeirão Preto, SP, Brazil; Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Medicina Interna, Ribeirão Preto, SP, Brazil.
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6
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Abstract
BACKGROUND Amazonian toxoplasmosis is a recently described form of Toxoplasma gondii infection, characterized by severe clinical and biological features and involvement of atypical genetic strains circulating through a forest-based cycle. Though mostly reported in French Guiana since 1998, this disease is probably under-diagnosed in other areas of South America. Few data are available on its specific features in children. METHODS We retrospectively included all children seen in Cayenne between 2002 and 2017, diagnosed with acute toxoplasmosis due to an atypical strain. Clinical and biological features and risk factors of Amazonian toxoplasmosis were recorded. RESULTS Eleven children met the inclusion criteria. The main clinical features were fever, lymphadenopathy, hepatomegaly and splenomegaly, as reported in adults. Less expected signs such as rhinorrhea, pharyngitis and maculopapular rash were also frequent. Cutaneous signs were associated with the involvement of a genetically atypical strain. Respiratory involvement was rare but associated with respiratory distress. Outcome was always favorable. Treatment by pyrimethamine/sulfadiazine or trimethoprim/sulfamethoxazole was always justified, efficient and well tolerated. Genetic analysis suggested the involvement of wild mammals in disease transmission, and strain-dependent virulence as one of the prognostic risk factors. CONCLUSIONS As in adults, pediatric Amazonian toxoplasmosis requires a systematic treatment. Symptoms such as skin rash, rhinorrhea and pharyngitis should not be mistaken for viral infections, when associated with lymphadenopathy or fever. Pediatricians working in South America should be familiar with these clinical presentations and with the different risk factors of Amazonian toxoplasmosis.
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Toxoplasmosis aguda diseminada fatal en una paciente adulta inmunocompetente proveniente del Pacífico colombiano. BIOMEDICA 2018; 38:19-23. [DOI: 10.7705/biomedica.v38i0.4087] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 04/04/2018] [Indexed: 11/21/2022]
Abstract
Se presenta el caso de una paciente inmunocompetente de 72 años de edad, proveniente del departamento del Chocó, con un cuadro clínico de 12 días de fiebre, cefalea, deterioro neurológico progresivo y rápida evolución a falla orgánica múltiple y muerte.En el estudio histopatológico de los tejidos obtenidos en la necropsia, se identificaron quistes tisulares morfológicamente sugestivos de ser bradizoítos de Toxoplasma gondii, lo que se confirmó mediante inmunohistoquímica en corazón, cerebro y músculo estriado.
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8
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Belal US, Norose K, Mohamed RM, Sekine S, Nukaga T, Ito K, Abdellatif MZ, Abdelgelil NH, Yano A. Quantitative assessment of the effects of sulfamethoxazole on Toxoplasma gondii loads in susceptible WT C57BL/6 mice as an immunocompetent host model. Parasitol Int 2015; 65:1-4. [PMID: 26384856 DOI: 10.1016/j.parint.2015.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 09/03/2015] [Accepted: 09/11/2015] [Indexed: 10/23/2022]
Abstract
The abundance of Toxoplasma gondii with or without sulfamethoxazole (SMX) treatment was evaluated with quantitative competitive polymerase chain reaction in various organs of wild-type C57BL/6 mice, a susceptible immunocompetent host, after peroral infection with a cyst-forming Fukaya strain of T. gondii. SMX affected different organs in three ways: T. gondii was reduced independently of SMX (skin and kidney); T. gondii was not eradicated with continuous treatment (brain, heart, and lung); and T. gondii was eradicated with continuous treatment (tongue, skeletal muscle, and small intestine). The SMX concentrations in the brains, hearts, and lungs were higher in infected mice than in uninfected mice. These results indicate that even in an immunocompetent host, chemotherapy is necessary to reduce the parasite load and thus reduce the risk of recurrent disease.
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Affiliation(s)
- Usama S Belal
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Kazumi Norose
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Rabie M Mohamed
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Shuichi Sekine
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Takumi Nukaga
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Kousei Ito
- Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Manal Z Abdellatif
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Noha H Abdelgelil
- Department of Parasitology, Faculty of Medicine, Minia University, Minia 61519, Egypt
| | - Akihiko Yano
- Department of Infection and Host Defense, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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de Souza Giassi K, Costa AN, Apanavicius A, Teixeira FB, Fernandes CJC, Helito AS, Kairalla RA. Tomographic findings of acute pulmonary toxoplasmosis in immunocompetent patients. BMC Pulm Med 2014; 14:185. [PMID: 25420956 PMCID: PMC4254211 DOI: 10.1186/1471-2466-14-185] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/07/2014] [Indexed: 02/06/2023] Open
Abstract
Background Toxoplasmosis is one of the most common human zoonosis, and is generally benign in most of the individuals. Pulmonary involvement is common in immunocompromised subjects, but very rare in immunocompetents and there are scarce reports of tomographic findings in the literature. The aim of the study is to describe three immunocompetent patients diagnosed with acute pulmonary toxoplasmosis and their respective thoracic tomographic findings. Acute toxoplasmosis was diagnosed according to the results of serological tests suggestive of recent primary infection and the absence of an alternative etiology. Case presentation From 2009 to 2013, three patients were diagnosed with acute respiratory failure secondary to acute toxoplasmosis. The patients were two female and one male, and were 38, 56 and 36 years old. Similarly they presented a two-week febrile illness and progressive dyspnea before admission. Laboratory tests demonstrated lymphocytosis, slight changes in liver enzymes and high inflammatory markers. Tomographic findings were bilateral smooth septal and peribronchovascular thickening (100%), ground-glass opacities (100%), atelectasis (33%), random nodules (33%), lymph node enlargement (33%) and pleural effusion (66%). All the patients improved their symptoms after treatment, and complete resolution of tomographic findings were found in the followup. Conclusion These cases provide a unique description of the presentation and evolution of pulmonary tomographic manifestations of toxoplasmosis in immunocompetent patients. Toxoplasma pneumonia manifests with fever, dyspnea and a non-productive cough that may result in respiratory failure. In animal models, changes were described as interstitial pneumonitis with focal infiltrates of neutrophils that can finally evolve into a pattern of diffuse alveolar damage with focal necrosis. The tomographic findings are characterized as ground glass opacities, smooth septal and marked peribronchovascular thickening; and may mimic pulmonary congestion, lymphangitis, atypical pneumonia and pneumocystosis. This is the largest series of CT findings of acute toxoplasmosis in immunocompetent hosts, and the diagnosis should be considered as patients that present with acute respiratory failure in the context of a subacute febrile illness with bilateral and diffuse interstitial infiltrates with marked peribronchovascular thickening. If promptly treated, pulmonary toxoplasmosis can result in complete clinical and radiological recovery in immunocompetent hosts.
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Affiliation(s)
- Karina de Souza Giassi
- Radiology Division, Hospital Sírio-Libanês, R, Dona Adma Jafet, 91, Bela Vista, SP 01308-050, Brazil.
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Undseth Ø, Gerlyng P, Goplen AK, Holter ES, von der Lippe E, Dunlop O. Primary toxoplasmosis with critical illness and multi-organ failure in an immunocompetent young man. ACTA ACUST UNITED AC 2013; 46:58-62. [PMID: 23902584 DOI: 10.3109/00365548.2013.813065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
An immunocompetent young man became critically ill with multi-organ failure due to primary toxoplasmosis. Although treated successfully, he relapsed after 1 y with bilateral toxoplasmic chorioretinitis. Severe disseminated toxoplasmosis rarely occurs in immunocompetent patients and may reflect an increased risk of relapse. Secondary prophylaxis must be considered.
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Affiliation(s)
- Øystein Undseth
- From the 1 National Center for NBC-medicine, Department of Acute Medicine, Oslo University Hospital , Ullevål
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Abhilash KPP, Roshine MK, Vandana K, Varghese GM. A probable case of acquired toxoplasmosis presenting as pyrexia of unknown origin in an immunocompetent individual. Int J Infect Dis 2013; 17:e1067-8. [PMID: 23726282 DOI: 10.1016/j.ijid.2013.03.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/27/2013] [Accepted: 03/31/2013] [Indexed: 11/28/2022] Open
Abstract
Disseminated toxoplasmosis presenting as a prolonged febrile illness is rare in immunocompetent individuals. We report a probable case of acquired toxoplasmosis in an immunocompetent woman who presented with fever of 6 months duration with lymphadenopathy and splenomegaly. The diagnosis was confirmed by serology and the presence of Toxoplasma gondii tachyzoites on bone marrow aspirate. The patient was successfully treated with pyrimethamine plus clindamycin.
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Affiliation(s)
- K P P Abhilash
- Department of Medicine 1, Christian Medical College, Vellore 632 004, Tamilnadu, India.
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Cuomo G, D'Abrosca V, Rizzo V, Nardiello S, La Montagna G, Gaeta GB, Valentini G. Severe polymyositis due to Toxoplasma gondii in an adult immunocompetent patient: a case report and review of the literature. Infection 2013; 41:859-62. [PMID: 23543435 DOI: 10.1007/s15010-013-0427-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 02/09/2013] [Indexed: 01/29/2023]
Abstract
Toxoplasmosis, a worldwide zoonosis caused by a coccidian parasite Toxoplasma gondii, is more often asymptomatic in immunocompetent patients. We report the case of a 38-year-old immunocompetent male with a polymyositis as the presenting manifestation of T. gondii infection. The patient was hospitalized for a 30-day history of fever (T max 39.5°C), muscle pain, and progressive weakness of the muscles. A diagnosis of polymyositis was made, and he was started on corticosteroid treatment, which caused no reduction of symptoms. After finding a positive polymerase chain reaction (PCR) assay for T. gondii, together with additional clinical findings, a diagnosis of acute toxoplasmosis was made. Specific treatment with pyrimethamine and sulfadiazine was started, with a progressive reduction of symptoms and normalization of laboratory tests.
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Affiliation(s)
- G Cuomo
- Infectious Disease Section, Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
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Yang Y, Zuo W, Hu J, Esch GW, Zuo Y. Hemophagocytic syndrome as uncommon presentation of disseminated toxoplasmosis in an immunocompetent adult from Chinese Kunming. Am J Trop Med Hyg 2013; 88:1209-11. [PMID: 23509123 DOI: 10.4269/ajtmh.12-0556] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hemophagocytic syndrome is a rare disease that is often fatal, despite treatment. An immunocompetent patient was presented with fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia, which conformed to a hemophagocytic syndrome diagnosis. Despite broad antibiotic treatment, the patient's clinical condition rapidly deteriorated and he died within 8 days of admission. Blood cultures and a serology test were negative; however, based on morphological characteristics, tissue cysts Toxoplasma gondii were found in the bone marrow. Based on polymerase chain reaction analysis, identity of the parasite was confirmed. Although very rare, T. gondii-associated hemophagocytic syndrome should be suspected in the case of cytopenia or multiorgan failure symptoms. To our knowledge, this is the first fatal toxoplasmosis case reported from China.
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Affiliation(s)
- YanFen Yang
- Key Laboratory for Animal Genetic Diversity and Evolution of High Education in Yunnan Province, Yunnan University, Kunming, China.
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Alvarado-Esquivel C, Estrada-Martínez S. Toxoplasma gondii infection and abdominal hernia: evidence of a new association. Parasit Vectors 2011; 4:112. [PMID: 21682896 PMCID: PMC3130683 DOI: 10.1186/1756-3305-4-112] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Accepted: 06/17/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We performed a retrospective, observational study in 1156 adult subjects from the general population of Durango City, Mexico, Fifty five subjects with a history of abdominal hernia repair and 1101 subjects without hernia were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. RESULTS The seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers was significantly higher in subjects with abdominal hernia repair than those without hernia. There was a tendency for subjects with hernia repair to have a higher seroprevalence of anti-Toxoplasma IgM antibodies than subjects without hernia. The seroprevalence of anti-Toxoplasma IgG antibodies in subjects with hernia repair was significantly higher in subjects ≥ 50 years old than those < 50 years old. Further analysis in subjects aged ≥ 50 years showed that the seroprevalence of anti-Toxoplasma IgG antibodies was also significantly higher in individuals with hernia repair than those without hernia (OR = 2.72; 95% CI: 1.10-6.57). Matching by age and sex further showed that the seroprevalence of Toxoplasma infection was significantly higher in patients with hernia repair than those without hernia (OR: 4.50; 95% CI: 1.22-17.33). CONCLUSIONS Results indicate that infection with Toxoplasma is associated with abdominal hernia. The contributing role of infection with Toxoplasma in abdominal hernia was observed mainly in subjects aged ≥ 50 years old. Our results might have clinical, prevention and treatment implications and warrant for further investigation.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico.
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Alvarado-Esquivel C, Torres-Berumen JL, Estrada-Martínez S, Liesenfeld O, Mercado-Suarez MF. Toxoplasma gondii infection and liver disease: a case-control study in a northern Mexican population. Parasit Vectors 2011; 4:75. [PMID: 21569516 PMCID: PMC3105944 DOI: 10.1186/1756-3305-4-75] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 05/13/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infection with the protozoan parasite Toxoplasma gondii may cause liver disease. However, the impact of the infection in patients suffering from liver disease is unknown. Therefore, through a case-control study design, 75 adult liver disease patients attending a public hospital in Durango City, Mexico, and 150 controls from the general population of the same region matched by gender, age, and residence were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and anti-Toxoplasma IgM antibodies. Socio-demographic, clinical and behavioral characteristics from the study subjects were obtained. RESULTS Seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers did not differ significantly in patients (10/75; 13.3%) and controls (16/150; 10.7%). Two (2.7%) patients and 5 (3.3%) controls had anti-Toxoplasma IgM antibodies (P = 0.57). Seropositivity to Toxoplasma did not show any association with the diagnosis of liver disease. In contrast, seropositivity to Toxoplasma in patients was associated with consumption of venison and quail meat. Toxoplasma seropositivity was more frequent in patients with reflex impairment (27.8%) than in patients without this impairment (8.8%) (P = 0.05). Multivariate analysis showed that Toxoplasma seropositivity in patients was associated with consumption of sheep meat (OR = 8.69; 95% CI: 1.02-73.71; P = 0.04) and rabbit meat (OR = 4.61; 95% CI: 1.06-19.98; P = 0.04). CONCLUSIONS Seropositivity to Toxoplasma was comparable among liver disease patients and controls. Further studies with larger sample sizes are needed to elucidate the association of Toxoplasma with liver disease. Consumption of venison, and rabbit, sheep, and quail meats may warrant further investigation.
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Mercier A, Ajzenberg D, Devillard S, Demar MP, de Thoisy B, Bonnabau H, Collinet F, Boukhari R, Blanchet D, Simon S, Carme B, Dardé ML. Human impact on genetic diversity of Toxoplasma gondii: example of the anthropized environment from French Guiana. INFECTION GENETICS AND EVOLUTION 2011; 11:1378-87. [PMID: 21600306 DOI: 10.1016/j.meegid.2011.05.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 05/02/2011] [Accepted: 05/03/2011] [Indexed: 10/18/2022]
Abstract
In French Guiana, severe cases of toxoplasmosis in immunocompetent patients are associated with atypical strains of Toxoplasma gondii linked to a wild neotropical rainforest cycle and a higher genetic diversity than usually observed for T. gondii isolates from anthropized environment. This raises the question of the impact of anthropization of the natural environment, on genetic diversity and on the population structure of T. gondii. However, few data are available on strains circulating in the anthropized areas from French Guiana. Seropositive animals originating mainly from anthropized sub-urban areas and punctually from wild environment in French Guiana were analyzed for T. gondii isolation and genotyping. Thirty-three strains were obtained by bioassay in mice and compared with 18 previously reported isolates chiefly originating from the Amazon rainforest. The genotyping analysis performed with 15 microsatellite markers located on 12 different chromosomes revealed a lower genetic diversity in the anthropized environment. Results were analyzed in terms of population structure by clustering methods, Neighbor-joining trees reconstruction based on genetic distances, F(ST,) Mantel's tests and linkage disequilibrium. They clearly showed a genetic differentiation between strains associated to the anthropized environment and those associated to the wild, but with some inbreeding between them. The majority of strains from the anthropized environment were clustered into additional lineages of T. gondii that are common in the Caribbean. In conclusion the two environmental populations "wild" and "anthropized" were genetically well differentiated. The anthropization of the environment seems to be accompanied with a decreased diversity of T. gondii associated with a greater structure of the populations. We detected potential interpenetration and genetic exchanges between these two environmental populations. As a higher pathogenicity in human of "wild" genotypes has been described, the interpenetration of both environments leads to hybridization between strains that may be at risk for human health.
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Affiliation(s)
- A Mercier
- Université de Limoges, IFR 145 GEIST, EA 3174 NeuroEpidémiologie Tropicale et Comparée, 2 rue du Dr Marcland, Limoges, 87025 Limoges Cedex, France.
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