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Toxoplasmosis in immunocompetent hosts

Authors
Michael Tolentino, MD
Eskild Petersen, MD, DMSc, DTM&H
Section Editor
Peter F Weller, MD, MACP
Deputy Editor
Jennifer Mitty, MD, MPH

INTRODUCTION

Toxoplasmosis, an infection with a worldwide distribution, is caused by the intracellular protozoan parasite, Toxoplasma gondii. Immunocompetent persons with primary infection are usually asymptomatic. However, in some immunocompetent hosts, T. gondii infection can present as an acute systemic infection or as ocular disease (eg, posterior uveitis).

After initial infection (even if asymptomatic), latent infection can persist for the life of the host. Immunocompromised individuals (eg, those with HIV/AIDS) can have reactivation of latent infection; such patients typically present with multiple central nervous system abscess-like, round processes with ring enhancement.

Toxoplasmosis in immunocompetent persons will be reviewed here. Toxoplasmosis in HIV-infected individuals, pregnant women, and neonates is discussed separately. (See "Toxoplasmosis and pregnancy" and "Congenital toxoplasmosis: Clinical features and diagnosis" and "Toxoplasmosis in HIV-infected patients".)

EPIDEMIOLOGY

Genotypes — There are three main T. gondii genotypes (types I, II, and III), which are prevalent in different geographic areas, and can impact the clinical presentation of T. gondii infection [1]. As an example, in Europe, where genotype II is present, 80 to 90 percent of individuals who become infected are asymptomatic. This is in contrast to South and Central America, where other genotypes are present, and infection is associated with a higher rate and increased severity of disease, such as retinochoroiditis in immunocompetent adults and children with congenital disease [2-4]. A mix of genotype I and II are the most prevalent in North America.

Prevalence — The seroprevalence of T. gondii infection ranges widely depending upon the geographic area. Seroepidemiologic surveys in the United States report that 11 percent of persons aged 6 to 49 are seropositive for T. gondii [5], whereas the seroprevalence is as high as 78 percent in some areas of Brazil [6].

                            

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Literature review current through: Jul 2017. | This topic last updated: Mar 17, 2017.
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