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Turkiye Parazitolojii Dergisi Mar 2024Congenital toxoplasmosis (CT) can have severe early and late sequelae in children. In this study, we aimed to evaluate the demographic, clinical, treatment...
OBJECTIVE
Congenital toxoplasmosis (CT) can have severe early and late sequelae in children. In this study, we aimed to evaluate the demographic, clinical, treatment characteristics of patients diagnosed with congenital infection and to highlight the long-term complications of the patients.
METHODS
Patients with CT were included in this study who were followed between 2010 and 2022 in Cukurova University Medical Faculty Hospital. Demographic, clinical and treatment characteristics were searched retrospectively. In the diagnosis of maternal and CT, IgM, IgG, IgG avidity, polymerase chain reaction tests were used along with clinical and symptoms.
RESULTS
Eighteen children (two twins) with CT and their mothers (n=16) were included in the study. Median age was 1 month. Ten (55.5%) of the children were male. CT diagnosis was made during pregnancy in 7 mothers (resulting in 8 babies) and postnatally in 9 mothers (resulting in 10 babies). The mothers of 5 (31.1%) babies with CT received spiramycin treatment during pregnancy. Three (60%) of 5 pregnant women who received spiramycin were diagnosed in the first trimester, 4 (80%) of the babies did not have any sequale and only 1 (20%) had microphthalmia. Ocular involvement was the most common presentation of the disease occured in 10 patients (55.5%), hydrocephalus and intracranial calcification developed in five patients (27.7%). Hearing loss developed in 2 (11.1%) patients. During the follow-up period, seizures developed in 3 patients (16.6%), microcephaly in 2 patients (11.1%), and neurodevolopmental retardation in 7 patients (38.8%), two of the patients had severe mental retardation. One (5.5%) patient with hydrocephalus died at 36 months of age due to complications after ventriculoperitoneal shunt application.
CONCLUSION
In our study, we observed severe sequelae in vision, hearing, and neurodevelopmental aspects in children diagnosed with CT at birth and during follow-ups. Early diagnosis and treatment of infants, along with the detection of infection during pregnancy, are essential in preventing severe sequelae that may arise due to CT.
Topics: Pregnancy; Infant, Newborn; Infant; Child; Humans; Female; Male; Retrospective Studies; Spiramycin; Toxoplasmosis, Congenital; Hydrocephalus; Immunoglobulin G
PubMed: 38449361
DOI: 10.4274/tpd.galenos.2024.74046 -
The Brazilian Journal of Infectious... 2024Chlamydia psittaci ‒ related community-acquired pneumonia associated to acute myocarditis was diagnosed in a young man with no medical history, and a professional...
Chlamydia psittaci ‒ related community-acquired pneumonia associated to acute myocarditis was diagnosed in a young man with no medical history, and a professional exposition to birds. The diagnosis was confirmed with positive specific polymerase chain reaction in bronchoalveolar lavage. The patient was treated with spiramycin for two weeks with anti-inflammatory treatment for myocarditis for three months. Clinical and biological improvement was rapidly observed followed by normalization of electrocardiogram and chest CT scan. No relapse was reported for over a two-year follow-up.
Topics: Humans; Male; Myocarditis; Psittacosis; Chlamydophila psittaci; Adult; Polymerase Chain Reaction; Community-Acquired Infections; Acute Disease; Young Adult
PubMed: 38679059
DOI: 10.1016/j.bjid.2024.103739 -
Food and Waterborne Parasitology Sep 2023The current study assessed the anti-parasitic impact of probiotics on infection either solely or challenged with diabetes in Swiss albino mice. The study design...
The current study assessed the anti-parasitic impact of probiotics on infection either solely or challenged with diabetes in Swiss albino mice. The study design encompassed group-A (diabetic), group-B (non-diabetic), and healthy controls (C). Each group was divided into infected-untreated (subgroup-1); infected and spiramycin-treated (subgroup-2); infected and probiotictreated (subgroup-3); infected and spiramycin+ probiotic-treated (subgroup-4). Diabetic-untreated animals exhibited acute toxoplasmosis and higher cerebral parasite load. Overall, various treatments reduced intestinal pathology, improved body weight, and decreased mortalities; nevertheless, probiotic + spiramycin exhibited significant differences. On day 7 post-infection both PD-1 and IL-17A demonstrated higher scores in the intestine of diabetic-untreated mice compared with non-diabetics and healthy control; whereas, claudin-1 revealed worsening expression. Likewise, on day 104 post-infection cerebral PD-1 and IL-17A showed increased expressions in diabetic animals. Overall, treatment modalities revealed lower scores of PD-1 and IL-17A in non-diabetic subgroups compared with diabetics. Intestinal and cerebral expressions of IL-17A and PD-1 demonstrated positive correlations with cerebral parasite load. In conclusion, toxoplasmosis when challenged with diabetes showed massive pathological features and higher parasite load in the cerebral tissues. Probiotics are a promising adjunct to spiramycin by ameliorating IL-17A and PD-1 in the intestinal and cerebral tissues, improving the intestinal expression of claudin-1, and efficiently reducing the cerebral parasite load.
PubMed: 37719029
DOI: 10.1016/j.fawpar.2023.e00201 -
Cureus Jan 2024Introduction Congenital toxoplasmosis (CT), despite being mostly subclinical at birth, can cause disabling disease in the fetus and lead to long-term sequelae. It is an...
Introduction Congenital toxoplasmosis (CT), despite being mostly subclinical at birth, can cause disabling disease in the fetus and lead to long-term sequelae. It is an important cause of chorioretinitis in infants and adolescents. Data on postnatal treatment are controversial, and there is a lack of universal guidelines. Methods A cross-sectional study of newborns with suspected CT was conducted between January 2007 and December 2021. Results Seventy-one patients with suspected CT were included. During pregnancy, 64 (90.1%) of the mothers underwent therapy, of which 59 (83.1%) with spiramycin. Amniocentesis identified one positive polymerase chain reaction assay. Most newborns were asymptomatic with normal laboratory, ophthalmological, and hearing screening. There was one case of hyperproteinorrachia. Fifty-seven patients (80.3%) started treatment: 42 (73.7%) with spiramycin, seven (12.3%) with pyrimethamine, sulfadiazine, and folinic acid (P+S+FA), and eight (14%) with P+S+FA intercalated with spiramycin. Adverse effects were found in 11 (19.3%) cases, mainly neutropenia. After investigation, we found three confirmed CT cases corresponding to 4.2% of suspected cases and an incidence of 0.4 per 10,000 births. All had normal clinical and laboratory exams in the neonatal period and started P+S+FA, fulfilling 12 months of therapy. During the follow-up, all presented normal psychomotor development without any long-term sequelae. Conclusion The lower incidence in our study, compared to the incidence in Europe, may be related to the decline in the prevalence of toxoplasmosis as well as the effectiveness of measures to prevent primary infection and a well-established program of antenatal screening, followed by the early initiation of treatment during pregnancy to prevent vertical transmission.
PubMed: 38406029
DOI: 10.7759/cureus.52971 -
Infection and Drug Resistance 2023Toxoplasmosis is a parasitic disease caused by that infects humans and many types of mammals and birds.
BACKGROUND
Toxoplasmosis is a parasitic disease caused by that infects humans and many types of mammals and birds.
OBJECTIVE
To investigate the effect of selenium nanoparticles (SeNPs) and (Pd) extracts loaded on SeNPs as a new agent to combat chronic infections in murine model as an alternative method to standard Spiramycin drug therapy.
METHODS
A total of 64 female mice were randomly divided into eight groups: GI: Normal control, GII: Positive control, GIII: infected and treated with Spiramycin, GIV: infected and treated with SeNPs, GV: infected and treated with aqueous extract of Pd, GVI: infected and treated with methanolic extract of Pd, GVII: infected and treated with aqueous extract of Pd loaded on SeNPs, GVIII: infected and treated with methanolic extract of Pd loaded on SeNPs. Date palm () fruits were identified and collected from the farms of Saudi Arabia. Preparation and characterization of SeNPs were done. The parasitological, histopathological examinations and biochemical changes were evaluated in all groups.
RESULTS
Parasitological results showed significant differences in GVII in comparison to GII while GVIII showed significant differences in comparison to GII and GIII. The histopathological section of the cerebral cortex showed obvious alterations in the infected compared with untreated control groups. Aqueous and methanolic extracts of loaded on SeNPs treatment showed improvement that indicated by few perivascular cuffing with few inflammatory cell infiltrations. Few granule cells with mild intracellular vacuolation and edema few deformed neurons with deep pyknotic nuclei. Microglia cells expression of Iba-1 and inflammatory cytokines (IL-4, IL-10 and INF-γ) in serum of all groups was higher in GII and lowest in GVIII followed by GVII.
CONCLUSION
SeNPs and extracts loaded on SeNPs could be a potent agent to combat infections.
PubMed: 38144223
DOI: 10.2147/IDR.S443047 -
Pharmacological Research Dec 2023Carrimycin is a potential immune-regulating agent for sepsis in patients with tumors. In this study, we investigated its effects on inflammation and immune function in... (Randomized Controlled Trial)
Randomized Controlled Trial
Carrimycin is a potential immune-regulating agent for sepsis in patients with tumors. In this study, we investigated its effects on inflammation and immune function in tumor patients with sepsis. In total, 120 participants were randomized to receive either carrimycin treatment (400 mg/day) (n = 62) or placebo (n = 58) for 7 days. The primary outcomes were immune-related indicators. Subsequently, patients were stratified into two subgroups (CD4 < 38.25% and CD8 < 25.195%). Ninety-nine participants were analyzed: 47 and 52 in the carrimycin and placebo groups, respectively. HLA-DR levels were rapidly increased in the carrimycin group; however, the placebo group initially experienced a decline in HLA-DR level at 1 day after administration. In the subgroup with CD4 < 38.25%, the carrimycin group exhibited significantly higher HLA-DR levels than the placebo group (2.270, P = 0.023) 1 day after administration and the degree of increase in HLA-DR in the carrimycin group was higher than that in the placebo group (2.057, P = 0.040). In the CD8 < 25.195% subgroup, the carrimycin group demonstrated significantly higher levels of CD8 T cells than the placebo group at 3 (2.300P = 0.027) and 5 (2.106, P = 0.035) days after administration. Carrimycin intervention led to significant reductions in the SOFA, APACHE II, PCT, and CRP levels. No adverse events were observed. In tumor patients with sepsis, particularly in those experiencing immunological suppression, carrimycin effectively regulates immune responses by increasing HLA-DR and CD8 T cell levels and plays an anti-infective role, reducing disease severity. (Chictr.org.cn, ID Number: ChiCTR2000032339).
Topics: Humans; CD8-Positive T-Lymphocytes; Biomarkers; HLA-DR Antigens; Sepsis; Inflammation; Immunity; Neoplasms; Double-Blind Method
PubMed: 37984505
DOI: 10.1016/j.phrs.2023.106991 -
Heliyon Aug 2023In this study, zinc oxide nanoparticles-coated with eugenol (ZnO@Eug) were synthesized and evaluated as a nanosuspension (NSus) formulation against in vitro and in vivo.
BACKGROUND
In this study, zinc oxide nanoparticles-coated with eugenol (ZnO@Eug) were synthesized and evaluated as a nanosuspension (NSus) formulation against in vitro and in vivo.
METHODS
An anti- activity assay for ZnO@Eug NSus was conducted in vitro, ex vivo, and in vivo. FTIR spectroscopy confirmed the formation of ZnO@Eug NSus by detecting several functional groups involved; EDX and SEM demonstrated the grain of ZnO-NPs embedded with Eug and compositional purity.
RESULTS
Surface charge (ZP) and size distribution (DLS) of ZnO@Eug NSus were determined to be -22.7 mV and 109.6 nm, respectively. According to the release kinetics, approximately 60% of the ZnO-NPs and Eug were released in the first 45 min. In the cytotoxicity assay, ZnO-NPs, Eug, and ZnO@Eug NSus had IC values of 71.85, 22.39, and 2.02 mg/mL, respectively. The therapeutic efficacy of ZnO@Eug against was 56.3%, which was not significantly different from that of spiramycin (58.9%) (Positive-control). The tissue tachyzoites in the liver, spleen, and peritoneum were less than 50% in groups treated with Eug, spiramycin, and ZnO@Eug NSus compared to the control. ZnO@Eug-treated groups showed a survival rate of up to 13 days.
CONCLUSIONS
The ZnO@Eug NSus demonstrated antiparasitic activity against with minimal toxic effects and high efficiency in increasing the survival of infected mice. The nanoformulations of ZnO-NPs incorporated with Eug could, in the future, be considered for treating toxoplasmosis in humans and animals if a detailed study was conducted to determine the precise dose and measure side effects.
PubMed: 37654466
DOI: 10.1016/j.heliyon.2023.e19295 -
Eye (London, England) May 2024Ocular toxoplasmosis is the most common cause of infectious posterior uveitis. Available literature is still conflicting regarding the incidence of recurrence during... (Review)
Review
Ocular toxoplasmosis is the most common cause of infectious posterior uveitis. Available literature is still conflicting regarding the incidence of recurrence during pregnancy as various calculations were employed in the different published studies. Although earlier reports have suggested a difference in presentation and an increase in severity during pregnancy, newer studies appear to show otherwise. Further diagnostic testing, including serologic and intraocular fluid sampling, may be indicated to increase the diagnostic accuracy in this special population of patients. The management of ocular toxoplasmosis during pregnancy is challenging as the foetus is additionally considered in the choice of treatment. Traditionally preferred anti-toxoplasmosis regimens containing antifolate drugs, such as pyrimethamine and trimethoprim-sulfamethoxazole, cannot be used routinely in pregnant patients, especially during the first trimester. This review includes literature on alternative treatments for ocular toxoplasmosis during pregnancy, including spiramycin and intravitreal treatment options.
Topics: Humans; Toxoplasmosis, Ocular; Pregnancy; Female; Antiprotozoal Agents; Pregnancy Complications, Parasitic; Pregnancy Complications, Infectious; Spiramycin; Anti-Bacterial Agents; Intravitreal Injections
PubMed: 38191658
DOI: 10.1038/s41433-023-02916-y -
The Journal of Maternal-fetal &... Dec 2023Therapeutic regimens for the treatment of toxoplasmosis are not standardized. Treatment strategy mainly at the end of the second and the beginning of the third...
Comparison of adverse reactions of spiramycin versus pyrimethamine/sulfadiazine treatment of toxoplasmosis in pregnancy: is spiramycin really the drug of choice for unproven infection of the fetus?
BACKGROUND
Therapeutic regimens for the treatment of toxoplasmosis are not standardized. Treatment strategy mainly at the end of the second and the beginning of the third trimester, especially in cases of negative prenatal diagnosis, is the least uniform. In some situations, the choice of treatment may be ambiguous, and adverse drug reactions of the therapy should be taken into consideration.
METHODS
Adverse drug reactions of anti-toxoplasma therapy with spiramycin ( = 77) versus pyrimethamine/sulfadiazine ( = 35) were compared in 112 pregnant women.
RESULTS
Up to 36.6% of women reported adverse reactions to the treatment overall ( = 41). Out of those 38.9% ( = 30) were treated with spiramycin and 31.4% ( = 11) with pyrimethamine/sulfadiazine. Toxic allergic reactions were the only indication for discontinuation of treatment in 8.9% of patients ( = 10), where 9.1% ( = 7) were reported in spiramycin and 8.6% ( = 3) in pyrimethamine/sulfadiazine cohort. Neurotoxic complications (acral paraesthesia) were significantly more frequent during the therapy with spiramycine in 19.5% ( = 15) compared to no cases in pyrimethamine/sulfadiazine group ( = .003). Other adverse drug reactions, such as gastrointestinal discomfort, nephrotoxicity, vaginal discomfort were reported, but the differences between the cohorts were not significant.
CONCLUSIONS
The superiority of one of the therapeutic regimens was not statistically demonstrated, since the differences in overall toxicity or incidence of toxic allergic reactions between the cohorts were not confirmed ( = .53 and = 1.00, respectively). However, although the isolated neurotoxicity of spiramycin was the only significant adverse reaction demonstrated in this study, pyrimethamine/sulfadiazine therapy should be preferred, because it is known to be more effective and with limited adverse reactions.
Topics: Female; Humans; Pregnancy; Spiramycin; Pyrimethamine; Sulfadiazine; Toxoplasmosis; Drug Therapy, Combination; Fetus; Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Toxoplasmosis, Congenital
PubMed: 37217458
DOI: 10.1080/14767058.2023.2215377 -
Pathogens and Global Health Oct 2023Toxoplasmosis is a frequent disease with an estimated prevalence of more than one billion human cases worldwide and over one million new infections each year. It is...
Toxoplasmosis is a frequent disease with an estimated prevalence of more than one billion human cases worldwide and over one million new infections each year. It is classified as a neglected tropical disease by the CDC since 2019. The disease may pass unnoticed in healthy individuals but could be fatal in the immunocompromised. Moreover, no effective treatment is available against the chronic form of the disease. Available anti- drugs are associated with many side effects. Therefore, search for new more reliable, more efficient, and less toxic therapeutic agents is a continuous endeavor. This study assesses the potential use of nitrofurantoin, a compound with well-established antimicrobial properties, as a potential anti- drug in vivo. It compares its efficacy to the commonly used anti- agent spiramycin by molecular and histopathological methods in acute and chronic infection. The results demonstrate a significant ability to eliminate the parasite ( < 0.001) whether used as mono- or combined therapy with spiramycin in the acute and chronic stages. When compared to the anti- drug spiramycin, nitrofurantoin achieved similar efficacy in the acute and chronic infection ( = 0.65 and = 0.096, respectively). However, better results were obtained when using a combination of both drugs ( < 0.001). Additionally, nitrofurantoin showed good inhibitory effects on the inflammatory process in the liver, kidney, and uterus of the experimentally infected animals. In conclusion, nitrofurantoin can be considered as a potential anti- agent. Nevertheless, further studies are recommended before consideration for clinical trials.
Topics: Female; Humans; Animals; Mice; Nitrofurantoin; Spiramycin; Persistent Infection; Disease Models, Animal; Toxoplasmosis; Toxoplasma
PubMed: 37032491
DOI: 10.1080/20477724.2023.2200577