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Abstract:

is a protozoan parasite that infects most species of warm-blooded animals, including humans. Members of the cat family Felidae are the only known definitive hosts for the sexual stages of and thus are the main reservoirs of infection. Serologic prevalence data indicate that toxoplasmosis is one of the most common infections of humans throughout the world. However, for the majority of persons, infection is asymptomatic. Primary infection in pregnant women can lead to severe disease in the fetus. Reactivation can cause significant morbidity in immunosuppressed persons, particularly persons with advanced AIDS. Prevention and treatment are available for each of these clinical situations; thus, the major diagnostic issues in toxoplasmosis are to correctly diagnose acute primary infection in pregnant women, diagnose congenital infection in newborns, and identify prior infection in immunosuppressed hosts. Serology is the main tool for each of the above-named clinical situations. Most recently, IgG avidity testing has emerged as an important tool for identifying recent infection in pregnant women, as IgM can be detected for over 6 months following primary infection. PCR is an important tool for identifying the parasite in the fetus. Interpretation of serology for the identification of acute infection in pregnant women can be complicated and often requires multiple tests—IgG, IgM, and IgA avidity testing. Use of a reference laboratory is often necessary in this setting.

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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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). doi:10.1128/9781555817381.ch138.f1

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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Image of FIGURE 2
FIGURE 2

Life cycle of doi:10.1128/9781555817381.ch138.f2

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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FIGURE 3

Algorithm for the serodiagnosis of toxoplasmosis in people greater than 1 year of age. doi:10.1128/9781555817381.ch138.f3

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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FIGURE 4

Algorithm for the diagnosis of antenatal congenital toxoplasmosis. doi:10.1128/9781555817381.ch138.f4

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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FIGURE 5

Algorithm for the diagnosis of neonatal toxoplasmosis. doi:10.1128/9781555817381.ch138.f5

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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Tables

Generic image for table
TABLE 1

IgG kits available commercially in the United States

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
Generic image for table
TABLE 2

IgM kits available commercially in the United States

Citation: Mcauley J, Jones J, Singh K. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138
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. 2015. , p 2373-2386. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch138

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