Toxoplasmosis

ExitCare ImageToxoplasmosis is a common and sometimes serious illness that is caused by the parasite Toxoplasma gondii. Infection often comes from the feces of infected cats. It can also come from eating poorly cooked meat, food contaminated by insects, contact with infected insects, or contact with infected soil. Infected cat feces may remain infectious in the soil for over 1 year. House cats living on cat food are usually not infectious. Cats who hunt for their food can be infectious.

CAUSES

  • Eating undercooked meat from an infected animal.

  • Handling waste or soil contaminated with cat feces.

  • Organ transplantation or blood transfusion from someone with the infection.

  • Passage of the infection from a mother to a newborn.

SYMPTOMS

Most people who get this infection have no symptoms at all. The most common symptom in otherwise healthy people is mild swelling of the lymph nodes in and around the neck. Less common symptoms may include:

  • Mild fever, chills, or sweats.

  • Headaches and muscle aches.

  • Sore throat.

  • Mild rash.

  • An enlarged spleen and liver.

  • Blurred vision, seeing spots, and sensitivity to bright light.

People with major abnormalities in their immune system are at risk to develop more serious and possibly life-threatening symptoms and disease. This includes people with HIV infection, organ, or bone marrow transplants, cancer of the blood or bone marrow, and people taking immunosuppressive drugs for any reason. Symptoms in this group of people may include:

  • Fever and enlargement of the liver, spleen, or lymph nodes.

  • Headaches, paralysis of a leg or arm, diminished consciousness, sleepiness, loss of memory, or coma.

  • Cough and shortness of breath.

  • Chest pain and an abnormal heartbeat.

DIAGNOSIS

  • A blood test can be used to test for antibodies to Toxoplasma gondii. This test shows if you have been exposed to the parasite.

  • Diagnosis of toxoplasmosis of the eye requires consultation with an eye doctor (ophthalmologist).

  • Many other tests may be recommended if you are an immunocompromised person. This may include X-rays, scans of different types, and blood tests and tissue samples (biopsies) of certain organs.

TREATMENT

  • Except for people with eye symptoms, most otherwise healthy people get better in weeks or a few months without any specific treatment. It is very rare for severe disease to occur in otherwise healthy people. Over-the-counter medicines such as acetominophen or aspirin may be recommended for fever or mild pain. If symptoms are more severe and long-lasting, other drugs may be prescribed by your caregiver.

  • The type of treatment for toxoplasmosis of the eye is highly dependent upon findings from a thorough exam by an ophthalmologist.

  • Toxoplasmosis in an immunocompromised person requires aggressive prescription drug therapy as well as very careful follow up with your caregiver.

PREVENTION

  • If you have HIV, the best way to prevent serious toxoplasmosis disease is to take your HIV medicines. Your caregiver may prescribe medicines to prevent infection if your CD4 count (a type of white blood cell) is too low.

  • Cook all meat thoroughly before eating it.

  • Keep house cats indoors. Feed them only store-bought foods. Always wash your hands after cleaning a cat litter box.

  • Avoid outdoor cats.

  • If you are an immunocompromised person and have a cat, wear gloves and a face mask when cleaning a cat litter box. Or, do not have a cat in your home, or do not clean cat litter boxes.

  • If you have an immune compromising illness, you take immunosuppressive drugs for any reason, or you have received an organ or bone marrow transplant, your caregiver may prescribe medicine to prevent a symptomatic toxoplasmosis infection. For transplant patients, this often depends on blood test results from both you and your organ donor.

HOME CARE INSTRUCTIONS

  • Take all medicines as directed by your caregiver.

  • Keep all follow-up appointments as directed by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have a fever.

  • You feel confused.

  • You have seizures.

  • You develop swollen lymph glands.

  • You have muscle aches.

  • You have night sweats.