No abstract available.
Drug Therapy, Combination ; Female ; Human ; Infant ; Male ; Serologic Tests ; Toxoplasma/immunology ; Toxoplasmosis, Congenital/complications ; Toxoplasmosis, Congenital/diagnosis ; Toxoplasmosis, Congenital/pathology*

Toxoplasma gondii, an intracellular coccidian protozoan, is the causative agent of toxoplasmosis, a widespread infection affecting various birds and mammals including humans. In immunocompetent hosts, the infection is usually asymptomatic and benign. Toxoplasmosis is either congenital or acquired. In general prenatal therapy of congenital toxoplasmosis is beneficial in reducing the ncy of infant infection. Therapies are based primarily on spiramycin because of the relative lack of toxicity and high concentration achieved in the placenta. Clindamycin is the standard drug for chemoprophylaxis in newborn infants, and is directed at preventing the occurrence of retinochoroiditis as a late sequel to congenital infection. The standard treatment for acquired toxoplasmosis in both immunocompetent and immunodeficient patients is the synergistic combination of pyrimethamine and sulphonamides. Toxoplasmic encephalitis is tbe most common manifestation of acquired toxoplasmosis in immunocompromised patients and if not treated is fatal. However, because of toxicity, the therapeutic efficacy of pyrimethamine sulphonamide combinations may be seriously limited in immunodeficient patients. We have experienced a case of toxoplasmosis during the workup of habitual aborter. So we report this case with a brief review of literatures.
Birds ; Chemoprevention ; Clindamycin ; Encephalitis ; Humans ; Immunocompromised Host ; Infant ; Infant, Newborn ; Mammals ; Placenta ; Pyrimethamine ; Spiramycin ; Toxoplasma ; Toxoplasmosis* ; Toxoplasmosis, Congenital

Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.
Animals ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Humans ; Incidence ; Infant, Newborn ; Iran ; Mass Screening ; Public Health ; Risk Factors ; Toxoplasmosis ; Toxoplasmosis, Congenital ; Zoonoses

Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.
Animals ; Congenital, Hereditary, and Neonatal Diseases and Abnormalities ; Humans ; Incidence ; Infant, Newborn ; Iran ; Mass Screening ; Public Health ; Risk Factors ; Toxoplasmosis ; Toxoplasmosis, Congenital ; Zoonoses

Congenital toxoplasmosis is caused by vertical transmission of Toxoplasma gondii from the mother during pregnancy. The road clinical spectrum of congenital toxoplasmosis ranges from stillbirth or death shortly after birth to survival with either cerebral damage or mild or subclinical disease, consisting usually of ocular involvement. Recently we experienced a neonate with congenital toxoplasmosis. The diagnosis of congenital toxoplasmosis was confirmed on the basis of clinical findings such as chorioretinitis, CT findings of multiple cerebral calcifications calcifications, hydrocephalus, and positive serologic test for toxoplasma IgM anti body. Therefore, we report our case with a review of related literature.
Chorioretinitis ; Diagnosis ; Humans ; Hydrocephalus ; Immunoglobulin M ; Infant, Newborn* ; Mothers ; Parturition ; Pregnancy ; Serologic Tests ; Stillbirth ; Toxoplasma ; Toxoplasmosis, Congenital*

Some parasitic diseases are more prevalent in children than in adults. Such agespecific diseases usually result from the mode of infection. Enterobiasis and head lice infestations are contact-borne. Congenital toxoplasmosis is a transplacental infection. Hepatic capillariasis results from contact with an environment contaminated with cat stools. Enterobiasis is the most common helminthic disease in children. The diagnosis and treatment is difficult because of its characteristic life cycle: eggs are present at the end of the life of the female adult worm. Vigorous screening and repeated chemotherapy for the entire family and contact group are required. Recently, there have been reports of congenital toxoplasmosis. There may be an increase in the number of cases of toxoplasmosis owing to the increase in the number of stray cats. Cryptosporidiosis does not evoke serious illness in immunocompetent children, while severe diarrhea can occur in immunocompromised children. One case of hepatic capillariasis has been reported in Korea. Owing to its high morbidity and mortality, prompt diagnosis and treatment are required. Head lice infestation is easy to diagnose and is still an indication of public health status. Mass screening and prevention are required. In local clinics, parasitic diseases are rarely suspected, since their incidence is very low and the symptoms are usually non-specific, except in a few parasitic diseases. Therefore, a thorough evaluation of the symptoms and past history and appropriate laboratory tests are necessary.
Adult ; Animals ; Cats ; Child* ; Cryptosporidiosis ; Diagnosis ; Diarrhea ; Drug Therapy ; Eggs ; Enterobiasis ; Female ; Helminths ; Humans ; Incidence ; Korea ; Lice Infestations ; Life Cycle Stages ; Mass Screening ; Mortality ; Ovum ; Parasitic Diseases* ; Pediculus ; Public Health ; Toxoplasmosis ; Toxoplasmosis, Congenital

The diagnosis of congenital toxoplasmosis may be difficult due to diversity of symptoms. However, the diagonosis is very important for treatment and determination of the prognosis of infected infants. We recently experienced two cases of congenital toxoplasmosis. The first case was suspected as congenital infection with hydrocephalus that was detected by prenatal ultrasonography. Postnatal evaluation revealed positive latex agglutination and ELISA IgG antibodies, and negative ELISA IgM antibodies for Toxoplasma gondii. Histologic examination of the biopsied brain tissue revealed microcalcification. The second case presented with jaundice and intraventricular hemorrhage, and serological evaluation revealed positive latex agglutination and ELISA IgG antibodies, and negative ELISA IgM antibodies for T. gondii. The mother was positive for ELISA IgM antibodies as well as for latex agglutination and ELISA IgG antibodies. In the blood and CSF of both infants as well as in the blood of their mothers, Toxoplasma specific B1 gene was detected by polymerase chain reaction and Southern blot analysis. Based on these results, we have confirmed two cases of congenital toxoplasmosis whose presenting symptoms were hydrocephalus, seizure, or jaundice, and these cases represent the first series of congenital toxoplasmosis diagnosed in Korea by polymerase chain reaction.
Agglutination ; Antibodies ; Blotting, Southern ; Brain ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Hemorrhage ; Humans ; Hydrocephalus ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Jaundice ; Korea ; Latex ; Mothers ; Polymerase Chain Reaction* ; Prognosis ; Seizures ; Toxoplasma ; Toxoplasmosis ; Toxoplasmosis, Congenital* ; Ultrasonography, Prenatal

The diagnosis of congenital toxoplasmosis may be difficult due to diversity of symptoms. However, the diagonosis is very important for treatment and determination of the prognosis of infected infants. We recently experienced two cases of congenital toxoplasmosis. The first case was suspected as congenital infection with hydrocephalus that was detected by prenatal ultrasonography. Postnatal evaluation revealed positive latex agglutination and ELISA IgG antibodies, and negative ELISA IgM antibodies for Toxoplasma gondii. Histologic examination of the biopsied brain tissue revealed microcalcification. The second case presented with jaundice and intraventricular hemorrhage, and serological evaluation revealed positive latex agglutination and ELISA IgG antibodies, and negative ELISA IgM antibodies for T. gondii. The mother was positive for ELISA IgM antibodies as well as for latex agglutination and ELISA IgG antibodies. In the blood and CSF of both infants as well as in the blood of their mothers, Toxoplasma specific B1 gene was detected by polymerase chain reaction and Southern blot analysis. Based on these results, we have confirmed two cases of congenital toxoplasmosis whose presenting symptoms were hydrocephalus, seizure, or jaundice, and these cases represent the first series of congenital toxoplasmosis diagnosed in Korea by polymerase chain reaction.
Agglutination ; Antibodies ; Blotting, Southern ; Brain ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Hemorrhage ; Humans ; Hydrocephalus ; Immunoglobulin G ; Immunoglobulin M ; Infant ; Jaundice ; Korea ; Latex ; Mothers ; Polymerase Chain Reaction* ; Prognosis ; Seizures ; Toxoplasma ; Toxoplasmosis ; Toxoplasmosis, Congenital* ; Ultrasonography, Prenatal

Toxoplasmosis is an important cause of foodborne, inflammatory, as well as congenital abnormalities. There is an urgent need for safe and effective therapies to eliminate or treat this cosmopolitan infectious disease. A medicinal herbal plant, Meliae fructus, has been used to soothe the liver and kills worms in Chinese medicine. In this study, Meliae fructus ethanol extract was examined and screened for its anti-T. gondii activity. For anti-T. gondii activity screening, in vitro study of Meliae fructus extract using tachyzoit of T. gondii RH strain-infected HeLa cells was performed. Further, in vivo anti-T. gondii study using a mouse infection model was conducted. Safety of herbal compounds was evaluated in SD rats by treatment with Meliae fructus extract for 28 days. As a result, selectivity of Meliae fructus ethanol extract was 5.85, which was higher than sulfadiazine selectivity (2.06). We also performed an in vivo study to evaluate the anti-T. gondii activity of Meliae fructus extract in a mouse model. The inhibition rate of Meliae fructus extract was as high as that of sulfadiazine. These results demonstrate that Meliae fructus can successfully cure T. gondii infection and could be a promising native herb treatment for prevention of T. gondii infection.
Animals ; Asian Continental Ancestry Group ; Communicable Diseases ; Congenital Abnormalities ; Ethanol* ; HeLa Cells ; Humans ; Liver ; Mass Screening ; Melia* ; Mice ; Plants ; Plants, Medicinal ; Rats ; Sulfadiazine ; Toxoplasma ; Toxoplasmosis

OBJECTIVETo reveal the relationship among congenital Toxoplasma gondii (T. gondii) infection, T lymphocyte cell subsets in umbilical cord blood and pregnancy outcome.

METHODS784 umbilical cord blood samples were collected and information of pregnancy outcomes was collected in a hospital of Hefei city, Anhui province during March 2009 to May 2010. T. gondii IgM antibodies in the sera were detected by ELISA. For all neonates infected with T. gondii and 10 healthy neonates, T lymphocyte cell subsets were detected by flow cytometry.

RESULTSAccording to the detection results of T. gondii IgM antibodies, 784 neonates were divided into infection group (21 neonates) and control group (763 neonates). The body weight and 1 min Apgar score of infection group were (3116.4 ± 352.6) g and (8.21 ± 1.26) points, respectively, which were statistically lower than control group ((3220.1 ± 242.3) g and (8.77 ± 1.61) points, respectively) (P < 0.01). The proportion of adverse pregnancy outcome of infection group was 19.0% (4/21), which was statistically greater than control group (4.8%, 37/763) (P < 0.01). The percentage of CD(3)(+) T lymphocyte cells in umbilical cord blood in infection group with and without adverse pregnancy outcomes were (64.51 ± 5.27)% and (64.32 ± 4.56)%, respectively, which were statistically lower than control group ((69.32 ± 4.32)%) (P < 0.01). The ratio value of CD(4)(+)/CD(8)(+) in infection group with, without adverse pregnancy outcomes and control group are 1.39 ± 0.24, 1.64 ± 0.28 and 2.34 ± 0.46, respectively, which showed statistical difference between any 2 groups (P < 0.01).

CONCLUSIONT. gondii infection leads to adverse pregnancy outcomes and disorder of cellular immunity while T lymphocyte cell subsets are closely associated with adverse pregnancy outcome.

Case-Control Studies ; Female ; Fetal Blood ; cytology ; immunology ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Outcome ; T-Lymphocyte Subsets ; immunology ; Toxoplasmosis, Congenital ; immunology