Effective factors in the pathogenesis of Toxoplasmagondii

Toxoplasma gondii (T. gondii) is a cosmopolitan protozoan parasite in humans and animals. It infects about 30 % of the human population worldwide and causes potentially fatal diseases in immunocompromised hosts and neonates. For this study, five English-language databases (ScienceDirect, ProQuest, Web of Science, PubMed, and Scopus) and the internet search engine Google Scholar were searched. This review was accomplished to draw a global perspective of what is known about the pathogenesis of T. gondii and various factors affecting it. Virulence and immune responses can influence the mechanisms of parasite pathogenesis and these factors are in turn influenced by other factors. In addition to the host's genetic background, the type of Toxoplasma strain, the routes of transmission of infection, the number of passages, and different phases of parasite life affect virulence. The identification of virulence factors of the parasite could provide promising insights into the pathogenesis of this parasite. The results of this study can be an incentive to conduct more intensive research to design and develop new anti-Toxoplasma agents (drugs and vaccines) to treat or prevent this infection. In addition, further studies are needed to better understand the key agents in the pathogenesis of T. gondii.

Significant clinical outcome using pyrimethamine and clindamycin in cerebral toxoplasmosis with severe edema: a case report

Cerebral toxoplasmosis is a complication in HIV/AIDS patients that has recently increased in new cases due to increased HIV/AIDS incidents.

Case Presentation

An Indonesian male, 26-year old, complained of severe headache, left hemiparesis, and tremors. A brain computed tomography scan with contrast showed a large mass, extensive edema, and a significant midline shift resembling a brain tumor. The HIV test was positive, and CD4 decreased. The patient was treated with dexamethasone, mannitol, and pyrimethamine-clindamycin as therapy. After 2 weeks of treatment, the headache, hemiparesis, and tremor were clinically improved. Two months later, a brain computed tomography scan and MRI showed a good prognosis.

Clinical Discussion

The diagnosis of cerebral toxoplasmosis is based on a radiological examination and an HIV/AIDS test. Management of cerebral toxoplasmosis using pyrimethamine-clindamycin, while steroids are not recommended unless disproportionate cytotoxic edema is displayed and life-threatening.

Conclusion

A combination of pyrimethamine-clindamycin, and steroids can improve the prognosis of cerebral toxoplasmosis with severe edema.