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Toxoplasmosis

Protozoan Infection ยท Litter Box Disease

Symptoms and Complications

For most of us, the immune system never reaches a state where toxoplasmosis can get enough of a foothold to cause symptoms. However, a few healthy people suffer mild symptoms from toxoplasmosis infection.

About 80% to 90% of us show no symptoms when we first get toxoplasmosis. About 10% to 20% of us will develop symptoms that are similar to infectious mononucleosis ("mono"). There may be a low-grade fever, muscle aches, sore throat, and swollen glands. There may also be a mild anemia. Usually the only symptom is slightly swollen glands. These symptoms can last for a long time - in some cases, up to a year.

People with weak immune systems feel much worse, with high fever, chills and sweating, rashes, and possible inflammation of the brain (encephalitis), its lining (meningitis), the heart (myocarditis), the lungs (pneumonitis), and various other organs. Even people with strong immune systems very occasionally get severe disease.

Of people with AIDS, about 40% develop disease from toxoplasmosis, usually because of the reactivation of an old infection. Most of these infections involve the central nervous system. They cause conditions such as:

  • coma
  • loss of vision or other senses
  • meningoencephalitis (inflammation of the brain and its lining)
  • partial paralysis
  • tremors

In about 60% to 90% of AIDS-related cases of toxoplasmosis, the onset of the disease is quite slow and subtle. There may be changes in emotions, behavior, or cleanliness. Later, there may be numbness or weakness in the arm a leg. Eventually the person will drift off into a coma. About 15% to 25% of AIDS-related cases of toxoplasmosis are first noticed when the person has a seizure or bleeding in the brain.

People with AIDS need immediate treatment or the disease may be fatal. Even if they recover, they must usually stay on preventive medication indefinitely because the parasite is likely to reappear.

Women who already have toxoplasmosis infection and become pregnant have little to worry about. But if a woman becomes infected while pregnant, there's a risk the fetus will be infected. The risk is about 15% in the first trimester. Fetuses infected at this stage often miscarry. The risk of infection of the fetus rises to 30% if infection occurs in the second trimester and rises up to 60% if infection occurs in the third trimester.

Babies infected late in pregnancy rarely miscarry but instead have symptoms such as:

  • brain damage
  • enlarged spleen and liver
  • eye damage
  • jaundice
  • poor motor coordination
  • unusually small head
  • rash

Early blindness and death are all too likely in these cases. Less severe infections may not be obvious at birth. The baby often grows up into a healthy young adult. But around age 20 or 30, the eyesight starts to degenerate as toxoplasma attacks the retina, the light-sensitive membrane at the back of the eye. Ocular toxoplasmosis can cause pain, blurred vision, and permanent damage, including blindness. Recent evidence suggests that healthy people who catch toxoplasmosis as adults can also occasionally suffer ocular damage.


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