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  • 1. INFECTIOUS DISEASE OF PATHOLOGY (Protozoal Diseases) Toxoplasmosis Dr. Naila Awal
  • 2. • Causative organism- Toxoplasma gondii • Toxoplasma comes from- Toxo & Plasma Toxo bow shaped. . • Forms of toxoplasmaIt’s a bow shaped parasite 1) Tachyzoite-Most common infected form. 2) BradyzoitePresent in tissue cyst. 3) Oocyst
  • 3. Mode of Transmission • Tissue cyst containing bradyzoite .Ex- Ingestion of infected undercooked meat- e.g-Sushi Organ transplantation • Tachyzoite infection- Ex- Meat handler / Butcher Handling infected cat Handling of culture media of toxoplasma Transpalcental route • Oocyst infection- by contaminated food & drink.
  • 4. Clinical presentation • Acute toxoplasmosis- May be asymptomatic 1) Flu like syndrome- Fever, sore throat, rhinitis 2)Lymphadenopathy- most commonly posterior cervical lymph node. 3)Occasional rash
  • 5. Congenital toxoplasmosis- Very dangerous Sign1) Coroido- retinitis- Parasite multiply within choroid Inflammation of retina Mild illumination of vision to blindness. 2)Microcephaly / Hydrocephalus 3)Calcification of cerebral ventricle. 4)Convulsion
  • 6. Diagnosis of Toxoplasmosis Acute toxoplasmosis- Specimen1) Lymph node biopsy 2) Bone marrow aspiration 3)CSF 5) Peritoneal fluid 4)Broncho alveolar lavage Lab procedure1) Direct microscopy- Smear is taken in a glass slide air dry Leishman/ Giemsa stain Findings- Tachyzoite 2) Culture- Specimen is inocculated in – • corio-allantoic membrane of embryonated cheek egg/ • lab animal-mice incubate Observation. Observation- Bradyzoite.
  • 7. Congenital toxoplasmosis 1) Serology (Mother)- It is the best test for toxoplasmosis. Ig G + Ig M + Possibility of transmission to Fetus Patient is never infected with toxoplasmosis Patient got infected 1yr before Boderline + Repeat after 2 weeks Strongly + Toxoplasma + Boderline+/Toxoplasma –
  • 8. 2) Amniocentesis- For detection of DNA of toxoplasma. 3) Associated test TC of WBC- Leukocytosis DC- Lymphocytosis with atypical mononuclear cell. Fate of fetus 1) 2) Spontaneous abortion Congenital malformation.
  • 9. Diagnosis of toxoplasmosis in HIV positive patient By Ig G titer. • Ig G titer is used for diagnosis of reactivation of tissue cyst in HIV positive patient. • If Ig G titer is increased 16 folds Toxoplasmosis
  • 10. Histological findings Lymph nodePoster cervical lymph nodes commonly affected. • Findings1) Folicular hyperplesia with intense mitotic activity. 2) Reactive follicles are surrounded by small granuloma, composed of epithelioid cells. Rarely necrosis & Langhan’s giant cell are present. EyeFocal area of coagulation necrosis of retina surrounded by granulomatous inflammation in adjacent choroid & retina. Within necrotic retina- cyst of Toxoplasma can be found.
  • 11. Lymph node • Epithelioid granuloma • Follicular hyperplesia
  • 12. Indication of abortion in toxoplasmosis 1) If fetal infection is confirmed within 22weeks of gestation Induced abortion. 2)If mother is seroconvert within the 3 months Terminate the pregnancy.