00:00
Let’s talk briefly about the disease that's
caused by toxoplasmosis. In most immunocompetent
individuals, it is a mononucleosis-like syndrome.
You feel tired, you may have a fever and you
have no sense at all that this is toxoplasmosis.
You probably won't seek medical care and the
syndrome will go away, you will harbor the
toxoplasma for the rest of your life and that
will be the end of it. The real problem comes
if you happen to be pregnant, and in your
first trimester, and you get infected with
toxoplasma. The toxoplasma parasites will
go to the fetus. They will enter the fetus
and replicate in it with severe consequences
for the baby. They can infect many organs,
including the eye, leading to chorioretinitis.
00:53
They can infect the brain and the baby will
be born with severe brain defects such as
hydrocephalus. It can cause cirrhosis of the
infant’s liver or splenomegaly. So congenital
infection is really what we must avoid, if
you are just becoming pregnant or thinking
about it. A good doctor will do a toxoplasma
test to make sure that you're not infected.
01:20
If you are, if you show antibodies that means
you were infected in the past, it means that
you have cysts of the toxoplasma in you, but
it's not likely that they will constitute
a risk for the baby. If you are toxoplasma
negative, your physician should tell you,
avoid being infected, and if you are infected
during pregnancy, this is a real problem,
especially during the first trimester, and
then you will have to decide whether you are
going to take drugs or not to try and avoid
infection of the fetus, because it's never
a good idea to take drugs during pregnancy,
they may harm the fetus in themselves.
01:58
So you can see why this is a serious issue. Now
if you happen to harbor cysts, pseudocysts
of toxoplasma and you become immunosuppressed,
those cysts will produce active forms of the
parasite, they will circulate throughout your
system and they can infect the brain and the
heart, and cause very serious disease. So
pregnancy and immunosuppression are two conditions
that we would like to avoid.
02:21
How do you diagnose toxoplasmosis? You can
look for antibodies against the parasite.
02:27
This is something your physician will do right
away or should do, should you become pregnant,
or you can take biopsy specimens and look
at them under a microscope and see the characteristic
parasites which we saw at the beginning
of our lecture.
02:43
How do you prevent toxoplasmosis? You should
cook your meat very well of course, this goes
without saying, many of us love a little bit
rarity in our meat, but it's really from a
health standpoint, not a good idea, toxo is
only one of the many issues that can arise
if you don't cook your meat well. Be careful
cleaning your litter box. It's really a good
idea to wear gloves and if you are pregnant,
please let someone else do it. Do not do it
yourself, because you're just risking get
infected, because you don't know the status
of your cat and it's not worth the risk on
your fetus to clean the litter box. If you
are infected and need treatment, there are
some drugs that we have, but they are not
without side effects. One combination is Pyrimethamine,
which inhibits dihydrofolate reductase, an
essential enzyme in the parasite, which we
all also happen to have, so it's not without
side effects, plus sulfadiazine or another
combination, pyrimethamine plus clindamycin.