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Toxoplasmosis/Toxocariasis
Systemic II Exam III
42
Medical
Graduate
11/15/2012

Additional Medical Flashcards

 


 

Cards

Term

How many in US affected by toxo?

Worldwide?

Definition

60 million

500 million worldwide

Term
What is the leading cause of death due to foodborne illness in US?
Definition
Toxoplasmosis
Term
In which climates is toxo more prevalent?
Definition

Warm, moist, low altitude

High cat populations

Regions where they eat undercooked meat

Term
Primary hosts of toxo
Definition

CATS!

Birds and Mice may also

Term
How do humans contract toxo?
Definition
Fecal oocysts (from the cat) are either in food or directly ingested by, air, water, soil, litter box and food. 
Term
Main tissue where the toxoplasmosis gondii organism lodges
Definition

Muscle

Myocardium

Eye

Term
2 forms/stages of toxoplasmosis
Definition

Tachyzoite-active and mobile

Bradyzoite-dormant

Term
Manifestations of acquired toxo
Definition

Usually asymptomatic

If there are symptoms:

-non tender cervical lymphadenopathy

-flu like symptoms

-Maculopapuler rash that spares the palms and soles

-pneumonitis, hepatitis, myocarditis, encephalitis

Term
How does stage of pregnancy correlate to risk of transmission of toxo to fetus?
Definition
Later stages are associated with a greater risk of transmitting parasite to fetus
Term
How does the stage of pregnancy at which toxo is contracted correlate to severity of congenital toxoplasmosis
Definition
Earlier stages correlate to increased severity of manifestations
Term
What is the most common cause of human retinochoroiditis?
Definition
Toxoplasmosis
Term
Manifestations of congenital toxoplasmosis
Definition

Hydrocephaly/microcephaly

endocrine disorders

cerebral calcifications

rash

fever

psychomotor retardation

jaundice

lymphadenopathy

enlarged spleen

CSF abnormalities

80% eventually develop ocular complications

 

Term
Toxoplasmosis in immune-suppressed patient
Definition

Multi-organ infection

same as acquired plus confusion

focal lesion sof non-viral etiology in CNS

Encephalitis, pneumonitis, myocarditis, retinochoroiditis

 

Term
Most common serological tests for Toxoplasmosis
Definition

IgG then IgM if positive

-Enzyme Immune Assay (EIA)

-Indirect Fluorescent Antibody (IFA)

Term
Which tests for toxo help to determine the time of infection in pregnant individuals
Definition
IgG avidity
Term
Which serological test requires live toxo supply?
Definition
Sabin Feldman dye test
Term
Which toxo test is highly sensitive and specific and uses methylene blue?
Definition
Sabin-Feldman dye test
Term
Name some conditions that may cause false positive results on serological tests for toxoplasmosis
Definition

Many healthy people are seropositive

Those with RF or ANA in blood may give a positive result on ELISA or IFA

Term
What may cause a false negative result on serological tests for toxoplasmosis?
Definition
Reduced immune response
Term
3 situations where treatment of toxoplasmosis is mandated
Definition

Treated if:

-newborn

-ocular lesions are recurrent and threaten macula, ON or papillomacular bundle

-immunocompromised with CNS or ocular complications

Term
How long is classic triple therapy for toxo given?
Definition
Given for 6 weeks
Term
3 drugs included in classic triple therapy for toxo
Definition

Pyrimethamine

Sulfadiazine

Leucovorin calcium

Term
SE of pyrimethamine
Definition

rash

aplastic anemia

N&V

anorexia

abdominal cramps

dizziness

fever

malaise

dry mouth

Term
SE of Sulfadiazine
Definition

Stevens Johnson Syndrome

aplastic anemia

hepatitis

acute renal failure

fever

dizziness

HA 

N&V

diarrhea

rash/pruritis

photosensitivity

hematuria

Term
Why is leucovorin calcium part of the treatment regimen for toxo?
Definition
It is folinic acid so it counters the folate deficiency caused by pyrimethamine
Term
SE of Corticosteroids
Definition

Adrenal insufficiency

peptic ulcer

osteoporosis

N&V

Cataracts

HA

Mood swings

Hypertension

Hyperglycemia

etc.

Term
Corticosteroids are contraindicated for which toxoplasmosis patients?
Definition
Immunosuppressed patients
Term
Describe toxo prevention methods
Definition

Cook food thoroughly

Pregnant/immunocompromised avoid cat litter

Keep cats inside

Freeze meat a few days before using

Peel/wash food

General kitchen hygiene

Wear gloves when around soil

Teach children to wash hands

Term
Primary hosts of toxocara canis
Definition

Domestic animals, reactivated in female dogs during pregnancy

Transmitted to puppies

Term
How is toxocara canis transmitted to humans
Definition

Eggs in dog feces, also gets into the soil and can stay for months to years

Children especially can become infected from dirt or puppy or contaminated food

Term
What areas of the US have higher rates of toxocara canis
Definition
South central and southeastern US
Term
Rate of infection of toxocara canis in US population of adults? children?
Definition

14% of adults

30% of children

Term
What disease is caused by toxocara canis
Definition
Visceral Larva migrans
Term
What is the physiological reason for the manifestations of toxocara canis?
Definition
Related to larvae migration and subsequent inflammation
Term
Systemic manifestations of toxocara canis
Definition

Fever

abdominal pains

malaise

HA

anemia

anorexia

irritability

pneumonia

cough

wheezing

bronchitis

asthma

transient pulmonary infiltrates

spleen/liver enlargement

seizures

 

Term
Ocular manifestations of toxocara canis
Definition

Unilateral mostly

Focal retinal granuloma (b/w macula and nerve head)

chorioretinitis

uveitis

endophthalmitis

Term
Definitive test for diagnosis of toxocara canis
Definition

Tissue biopsy

However not usually done

Term
Lab tests for diagnosis of toxocara canis
Definition

Tissue biopsy

ELISA

 

Term
Which toxocara canis test is not useful in ophthalmic larva migrans?
Definition
ELISA
Term
2 methods for prevention of Toxocara canis infection
Definition

Deworming puppies

Appropriate hygiene

Term
How is mild disease from toxocara canis treated?
Definition

Monitored by physician but usually self-limiting without treatment

 

Term
Treatment of severe disease caused by toxocara canis
Definition

Steroids for respiratory and heart problems

Antihelmintic drugs

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