Changes

CNS signs are the most common presentation in immunocompromised patients suffering ''Toxoplasma'' infection or re-activation. Signs are due to intracranial mass lesions or encephalitis, and can include headaches, seizures, pyrexia, coma and focal neurological deficits. Ocular involvement is also possible and usually results from re-activation of a congenital infection. Inflammation of the choroid causes pain and visual disturbances. Occasionally, in severely immunocompromised patients, disease can be seen outwith the CNS and the eye. In these incidences, affected tissues and therefore clinical signs can be variable. For example, patients may suffer pneumonitis, myocarditism, high fevers or chills and polymyositis. Unless treated, these disseminated infections may be fatal.

CNS signs are the most common presentation in immunocompromised patients suffering ''Toxoplasma'' infection or re-activation. Signs are due to intracranial mass lesions or encephalitis, and can include headaches, seizures, pyrexia, coma and focal neurological deficits. Ocular involvement is also possible and usually results from re-activation of a congenital infection. Inflammation of the choroid causes pain and visual disturbances. Occasionally, in severely immunocompromised patients, disease can be seen outwith the CNS and the eye. In these incidences, affected tissues and therefore clinical signs can be variable. For example, patients may suffer pneumonitis, myocarditism, high fevers or chills and polymyositis. Unless treated, these disseminated infections may be fatal.

When infection is acquired for the first time during pregnancy, congenital toxoplasmosis can arise. This nmay also occur if a mother infected before conception becomes immunosuppressed during pregnancy. Foetuses infected congenitally may be aborted, stillborn, or born with toxoplasmosis. Infections later in gestation are more likely to give rise to a live but infected neonate. When neonates are born with toxoplasmosis disease can be severe, particularly if transplacental infection occured early in pregnancy. Signs can include rashes, icterus and hepatosplenomegaly, and there are four abnormalities that are characteristic of congenital toxoplasmosis:  retinochoroiditis, cerebral calcifications, hydrocephalus/microcephaly, and psychomotor retardation. Prognosis is poor. Many children with less severe infections and most infants born to mothers infected during the 3rd trimester appear healthy at birth but are at high risk of seizures, intellectual disability, retinochoroiditis, or other symptoms developing months or even years later.

When infection is acquired for the first time during pregnancy, congenital toxoplasmosis can arise. This nmay also occur if a mother infected before conception becomes immunosuppressed during pregnancy. Foetuses infected congenitally may be aborted, stillborn, or born with toxoplasmosis. Infections later in gestation are more likely to give rise to a live but infected neonate. When neonates are born with toxoplasmosis disease can be severe, particularly if transplacental infection occured early in pregnancy. Signs can include rashes, icterus and hepatosplenomegaly as well as retinochoroiditis, cerebral calcifications, hydrocephalus/microcephaly, and psychomotor retardation. These last four signs together are characteristic of congenital toxoplasmosis. Infants infected during the third trimester are less severely affected and tend to appear normal at birth. However, signs may develop months to years later, and can include seizures, retinochoroiditis and intellectual disability.

 

 

 

 

 

people with a healthy immune system have few symptoms and recover fully. Children born with congenital toxoplasmosis may be severely ill and die shortly after birth, or they may have no symptoms until months or years later. Some never become ill. Typical symptoms in newborns can include inflammation of the eyes (chorioretinitis), which can result in blindness, as well as enlargement of the liver and spleen, jaundice, rash, easy bruising, seizures, a large or small head, and mental retardation.

 

Toxoplasmosis acquired after birth in people with a healthy immune system seldom causes symptoms. When symptoms occur, they are usually mild and include swollen but painless lymph nodes, intermittent low fevers, a vague ill feeling, and sometimes a sore throat. Some people develop only chorioretinitis, with blurred vision, eye pain, and sensitivity to light. Chorioretinitis usually results from reactivation of congenital toxoplasmosis.

 

Symptoms of toxoplasmosis in people with a weakened immune system depend on the site of infection. Toxoplasmosis of the brain (encephalitis) produces symptoms such as weakness on one side of the body, trouble speaking, headache, confusion, seizures, and coma. Acute disseminated toxoplasmosis can cause a rash, high fever, chills, trouble breathing, and fatigue. In some people, infection causes inflammation of the liver (hepatitis), lungs (pneumonitis), or heart (myocarditis). The affected organ may stop functioning adequately (called organ failure). These types of toxoplasmosis can be life threatening.

===Laboratory Tests===

===Laboratory Tests===