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Chapter 135 :

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Abstract:

Serologic prevalence data indicate that toxoplasmosis is one of the most common infections of humans throughout the world. Toxoplasmosis can be categorized into four groups: (i) acquired in the immunocompetent patient; (ii) acquired or reactivated in the immunodeficient patient; (iii) congenital; and (iv) ocular. Acquired infection with in immunocompetent individuals is generally an asymptomatic infection. Secretions, excretions, body fluids, and tissues are potential specimens for direct observation of parasites but are generally unrewarding. The most important advantage of the immunoglobulin M (IgM) capture enzyme immunoassay (EIA) compared to indirect fluorescent antibody (IFA) is the increased detection of congenital infections: the IgM enzyme-linked immunosorbent assay (ELISA) was positive for 73% of serum samples from newborn infants with proven congenital toxoplasmosis, whereas only 25% of the same serum samples were found positive by an IFA IgM test. The currently recommended drugs work primarily against the actively dividing tachyzoite form of and do not eradicate encysted organisms (bradyzoites). infection is one of the most common parasitic infections worldwide and, in most instances, is of little clinical significance. The laboratory will need to use additional testing in an attempt to define the timing of infection in the case of pregnant women or the presence of actively replicating parasites in the case of the fetus, neonate, or immunosuppressed host.

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135

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Enzyme-Linked Immunosorbent Assay
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Toxoplasma gondii
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FIGURE 1

Three life stages of . (A) Tachyzoites, Giemsa stain; (B) cyst with bradyzoites in brain tissue, Giemsa stain; (C) sporulated oocysts, unstained. (Photographs courtesy of J. P. Dubey, U.S. Department of Agriculture, Beltsville, MD.)

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135
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Image of FIGURE 2
FIGURE 2

Algorithm for the serodiagnosis of toxoplasmosis in people greater than 1 year of age.

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135
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Image of FIGURE 3
FIGURE 3

Algorithm for the antenatal diagnosis of congenital toxoplasmosis.

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135
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Image of FIGURE 4
FIGURE 4

Algorithm for the diagnosis of neonatal toxoplasmosis.

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135
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Tables

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TABLE 1

IgG kits available commercially in the United States

Abbott Laboratories, Diagnostics Division, North Chicago, IL 60064; Bayer Diagnostics, 511 Benedict Ave., Tarrytown, NY 10591; Beckman Coulter, 4300 N. Harbor Blvd., Fullerton, CA 92834; Biokit USA, 113 Hartwell Ave., Lexington, MA 02173; bioMérieux, 595 Anglum Dr., Hazlewood, MO 63042; Bio-Rad, 4000 Alfred Nobel Dr., Hercules, CA 94547; Biotecx Laboratories, 6023 S. Loop East, Houston, TX 77033; Biotest Diagnostics Corp., 66 Ford Rd., Suite 131, Denville, NJ 07834; Diagnostic Products Corp., 5700 W. 96th St., Los Angeles, CA 90045; Diamedix Corp., 2140 N. Miami Ave., Miami, FL 33127; DiaSorin, P.O. Box 285, Stillwater, MN 55082; GenBio, 15222 A Avenue of Science, San Diego, CA 92128; Hemagen Diagnostics, 34–40 Bear Hill Rd., Waltham, MA 02154; Inverness Medical Professional Diagnostics, 2 Research Way, Princeton, NJ 08540; Meridian Bioscience, 3471 River Hills Dr., Cincinnati, OH 45244; Roche Diagnostics Corp., 9115 Hague Rd., Indianapolis, IN 46250.

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135
Generic image for table
TABLE 2

IgM kits available commercially in the United States

For company addresses, see Table 1 , footnote

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135
Generic image for table
TABLE 3

Guide to general interpretation of serology results obtained with IgG and IgM commercial assays

Citation: McAuley J, Jones J, Singh K. 2011. , p 2127-2138. In Versalovic J, Carroll K, Funke G, Jorgensen J, Landry M, Warnock D (ed), Manual of Clinical Microbiology, 10th Edition. ASM Press, Washington, DC. doi: 10.1128/9781555816728.ch135

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