Toxoplasmosis in immunocompromised patients

Česká verzia

Authors: L. Machala ¹; P. Kodym ²; M. Malý ³ ; M. Geleneky ¹; O. Beran ⁴; D. Jilich ⁴
Authors place of work: Klinika infekčních, parazitárních a tropických nemocí, 3. lékařská fakulta, Univerzita Karlova v Praze a Nemocnice Na Bulovce ¹; Národní referenční laboratoř pro toxoplasmózu, Státní zdravotní ústav Praha ²; Oddělení biostatistiky a informatiky, Státní zdravotní ústav Praha ³; Klinika infekčních a tropických nemocí, 1. lékařská fakulta, Univerzita Karlova v Praze a Nemocnice Na Bulovce ⁴
Published in the journal: Epidemiol. Mikrobiol. Imunol. 64, 2015, č. 2, s. 59-65
Category: Souhrnné sdělení

Summary

In humans, toxoplasmosis mostly occurs as a latent infection, but in immunocompromised individuals, the agent may reactivate and cause severe to life-threatening disease. HIV positive individuals and transplant recipients, in particular hematopoietic stem cell transplant and heart transplant recipients, are at highest risk. The disease most often affects the central nervous system but can involve any organ. Because of the alteration of the immune response in these patients, the serodiagnosis is not reliable and direct detection of the causative agent is needed – namely by microscopy and DNA PCR. If inadequately treated or left untreated, toxoplasmosis generally has a fatal prognosis in immunocompromised patients and therefore, the treatment must be started as early and energetically as possible. The gold standard both in the treatment of reactivation and secondary prophylaxis is the pyrimethamine-sulfadiazine combination while co-trimoxazole can be used in the primary prophylaxis for high-risk patients.

Key words:
immune disorders – infection – Toxoplasma gondii – HIV – transplantation – diagnosis – treatment

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