Last reviewed: November 2017
Last updated: April  2017

Summary

Definition

History and exam

Key diagnostic factors

  • chorioretinitis
  • focal neurologic deficit

Other diagnostic factors

  • blurry vision
  • slurred speech
  • headache
  • unsteady gait
  • confusion
  • fever
  • lymphadenopathy
  • fetal microcephaly
  • fetal intracranial calcification
  • fetal hydrocephalus
  • fetal intrauterine growth retardation
  • seizure
  • malaise
  • hepatitis
  • pneumonitis
  • myocarditis
  • cardiac, pulmonary, or disseminated disease in transplant recipients

Risk factors

  • immunosuppression
  • exposure during pregnancy
  • residence in a high-risk area
  • ingestion of undercooked or raw meat
  • exposure to cat feces
  • heavy exposure to soil
  • ingestion of unwashed unpeeled raw fruits and vegetables
  • occupational exposure

Diagnostic investigations

1st investigations to order

  • anti-Toxoplasma IgG (serum)
  • anti-Toxoplasma IgM (serum)
  • CT (with IV contrast) or MR imaging of brain
Full details

Investigations to consider

  • anti-Toxoplasma IgA (serum)
  • anti-Toxoplasma IgE (serum)
  • Toxoplasma-specific IgG avidity index (serum)
  • differential agglutination test (AC/HS)
  • PCR (body fluids and tissue)
  • biopsy
Full details

Emerging tests

  • IgG or IgM Immunoblot (serum)
  • enzyme-linked immunosorbent spot (ELISPOT) assay
  • IFN-gamma release assay (IGRA)
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Assistant Professor

Department of Medicine

Division of Infectious Diseases and Immunology

New York University School of Medicine

New York

NY

Disclosures

SH declares that she has no competing interests.

Professor of Medicine (Infectious Diseases) and Microbiology and Immunology

Albert Einstein College of Medicine

Bronx

NY

Disclosures

KK is on the advisory board for the Sanford Guide for Antibiotic Therapy.

Peer reviewers VIEW ALL

Professor of Parasitology

University of Pisa

School of Medicine

Pisa

Italy

Disclosures

FB declares that he has no competing interests.

Gastroenterologist

Dartmouth-Hitchcock Nashua

Nashua

NH

Disclosures

SN declares that he has no competing interests.

Professor of Medicine

University of Connecticut Health Center

Farmington

CT

Disclosures

GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.

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