Toxoplasmosis

Diagnosis

Toxoplasmosis diagnosis is primarily based on laboratory blood tests, which can detect two types of antibodies. The first type indicates an active and recent infection with the parasite, while the second type suggests a past infection. Depending on the results, your healthcare provider may recommend repeating the test after two weeks to confirm the diagnosis. Further diagnostic measures may be necessary based on additional symptoms, health status, and other factors.

Eye symptoms
For eye symptoms, an examination by an ophthalmologist, a doctor specializing in eye diseases, is required. The exam may involve using special lenses or cameras to view the internal tissues of the eye.

Brain and other nervous system symptoms
Symptoms suggesting brain inflammation may lead to several tests, including:

• Brain imaging: Magnetic resonance imaging (MRI) or Computed tomography (CT) scans create detailed images of the brain and can reveal abnormalities linked to toxoplasmosis.
• Cerebral spinal fluid (CSF) test: This test involves analyzing the fluid that surrounds and protects the brain and spinal cord to detect the presence of toxoplasma.
• Brain tissue examination: In rare cases, a sample of brain tissue may be removed to identify the parasite.

Pregnancy
Diagnostic blood test may be ordered if:

• Symptoms suggest an active Toxoplasma infection.
• Ultrasound images of the fetus show abnormalities associated with toxoplasmosis.
• The infection has a potential to be transmitted to the baby in the womb. In such cases, the diagnosis involves testing the amniotic fluid, which is sampled using a fine needle through the skin.

Newborns
For newborns, blood tests are conducted if there is a suspicion of toxoplasmosis. A positive test result leads to comprehensive monitoring and testing, including:

• Ultrasound or CT imaging of the brain.
• Tests on the fluid surrounding the brain and spinal column.
• Eye examinations.
• Hearing tests.
• Electroencephalogram, a test that measures brain activity.

Treatment

Treatment programs for toxoplasmosis typically span from two to six weeks, although some individuals may experience recovery within a few days. Full recovery from brain damage caused by the parasite may require three weeks to six months. Active infections are addressed with medication, with the specific regimen and dosage tailored to factors such as the severity of the disease, the status of the immune system, the site of infection, and, in the case of pregnant individuals, the stage of pregnancy.

You can be prescribed a mix of medications by your healthcare provider. Among them includes:

• Pyrimethamine (Daraprim): These fights illnesses brought on by small organisms. It could hinder how well the body uses folic acid. Liver damage and bone marrow suppression are two more potential long-term negative effects.
• Leucovorin calcium: This counteracts the pyrimethamine’s effects on the action of folic acid.
• Sulfadiazine: This antibiotic and pyrimethamine are frequently administered together. Azithromycin, clindamycin, and other medications are examples.
• Glucocorticosteroids: Apart from standard medical treatment, glucocorticosteroids, which are anti-inflammatory steroids, can also be used to treat eye diseases.

Infants may require medication treatment for one to two years, and regular follow-up appointments are essential to monitor for side effects, visual impairments, as well as intellectual and physical development. Even after feeling better, continued treatment may be necessary to ensure complete elimination of active parasites. If toxoplasmosis is detected during pregnancy, medication is typically prescribed throughout the pregnancy period. Treatment for congenital toxoplasmosis may extend up to a year. Individuals with compromised immune systems may require lifelong treatment.