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Outcomes of trimethoprim/ sulfamethoxazole treatment for ocular toxoplasmosis in Congolese patients.BMC Ophthalmology Oct 2023Ocular toxoplasmosis (OT) is the leading cause of infectious posterior uveitis in several areas worldwide. The combination of Trimethoprim/Sulfamethoxazole (TMP/SMX) has...
BACKGROUND
Ocular toxoplasmosis (OT) is the leading cause of infectious posterior uveitis in several areas worldwide. The combination of Trimethoprim/Sulfamethoxazole (TMP/SMX) has been presented as an attractive alternative to the "classic' treatment therapy (Pyrimethamine/Sulfadiazine).
METHODS
A prospective study was carried out between February 2020 and September 2021 in 2 ophthalmic centers in Kinshasa. This study aimed to describe TMP/SMX treatment outcomes for OT in a cohort of immunocompetent Congolese patients.
RESULTS
54 patients were included, with a mean age at presentation of 37.5 ± 13.6 years old and a Male-Female ratio of 1.45:1. Three patients (5.6%) presented a recurrence during the follow-up period. At the end of the follow-up, improvement in VA and resolution of inflammation concerned 75.9% and 77.5% of patients, respectively. Cataracts (3.7%), macular scars (3.7%), and vitreous opacities (3.7%) were the principal causes of non-improvement in VA. Treatment-related adverse events were present in 10 patients (18.5%); gastrointestinal (14.8%) and dermatological (3.7%) adverse events were the most frequent. Dermatological adverse events led to discontinuation of treatment.
CONCLUSION
TMP/SMX regimen appears to be a safe and effective treatment for OT in Congolese patients. The low cost and the accessibility of the molecules make this regimen an option for treating OT in resource-limited countries.
Topics: Humans; Male; Female; Young Adult; Adult; Middle Aged; Trimethoprim, Sulfamethoxazole Drug Combination; Toxoplasmosis, Ocular; Pyrimethamine; Prospective Studies; Democratic Republic of the Congo
PubMed: 37907920
DOI: 10.1186/s12886-023-03183-x -
Korean Journal of Ophthalmology : KJO Dec 2019This study sought to describe the different clinical features and presentations of primary ocular toxoplasmosis in a setting not demonstrating an outbreak of disease.
PURPOSE
This study sought to describe the different clinical features and presentations of primary ocular toxoplasmosis in a setting not demonstrating an outbreak of disease.
METHODS
This was a retrospective review of patients presenting to uveitis management services in Auckland and Hamilton, New Zealand between 2003 to 2018 with uveitis and positive toxoplasmosis immunoglobulin M serology.
RESULTS
We identified 16 patients with primary acquired toxoplasmosis infection and ocular involvement. The mean age was 53 years. Systemic symptoms were reported in 56% (9 / 16). Visual acuity was reduced to 20 / 30 or less in 50% of patients (8 / 16). A single focus of retinitis without a pigmented scar was the salient clinical feature in 69% (11 / 16). Optic nerve inflammation was the sole clinical finding in 19% (3 / 16). Bilateral arterial vasculitis was the sole clinical finding in 13% (2 / 16). A delay in the diagnosis of toxoplasmosis of more than two weeks occurred in 38% (6 / 16) due to an initial alternative diagnosis. Antibiotic therapy was prescribed in all cases. Vision was maintained or improved in 69% (11 / 16) at the most recent follow-up visit (15 months to 10 years). Relapse occurred in 69% (11 / 16), typically within four years from the initial presentation.
CONCLUSIONS
Primary ocular toxoplasmosis presenting in adulthood is a relatively uncommon cause of posterior uveitis in New Zealand. This condition should be considered in any patient presenting with retinitis or optic nerve inflammation without a retinochoroidal scar. This disease tends to relapse; thus, close follow-up is required.
Topics: Adult; Aged; Anti-Bacterial Agents; Antiprotozoal Agents; Endemic Diseases; Eye Infections, Parasitic; Female; Health Services; Humans; Male; Middle Aged; New Zealand; Optic Neuritis; Retinal Vasculitis; Retinitis; Retrospective Studies; Toxoplasmosis, Ocular; Uveitis, Posterior; Vision Disorders; Visual Acuity; Young Adult
PubMed: 31833248
DOI: 10.3341/kjo.2019.0092 -
The American Journal of Tropical... Dec 2020Peripheral blood mononuclear cells (PBMC) from patients with ocular toxoplasmosis were challenged with total antigens from lysate (TATL) in a cytokine release assay...
Peripheral blood mononuclear cells (PBMC) from patients with ocular toxoplasmosis were challenged with total antigens from lysate (TATL) in a cytokine release assay (CRA), run during the inactive period of the disease. Increased interferon gamma (IFN-γ) levels were detected after PBMC stimulation with either ME49 reference strain ( = 0.0015) or local TgCkAr-11-9 isolate ( = 0.0012), as compared with those recorded under basal conditions. TATL from TgCkAr11-9 isolate induced a higher release of IFN-γ than ME49 strain in CRA from all tested patients ( = 0.02). The median value of IFN-γ release on TgCkAr-11-9 stimulation (26.03 pg/mL) allowed the classification of patients into high- or low-/non-IFN-γ releasers. Clinical correlations were established with both groups. The results obtained in this study suggest the need to include local strains when performing CRA with TATL.
Topics: Adult; Aged; Female; Humans; Interferon-gamma; Interleukin-10; Leukocytes, Mononuclear; Male; Middle Aged; Toxoplasma; Toxoplasmosis, Ocular; Young Adult
PubMed: 32901605
DOI: 10.4269/ajtmh.20-0124 -
Pathogens (Basel, Switzerland) Mar 2022The appearance and spread of parasitic diseases around the world aroused the interest of the scientific community to discover new animal models for improving the quality... (Review)
Review
The appearance and spread of parasitic diseases around the world aroused the interest of the scientific community to discover new animal models for improving the quality and specificity of surveys. is a rodent native to South America, an easy handling model, with satisfactory longevity and reproducibility. is susceptible to toxoplasmosis and can be used as experimental model for the study the pathogenesis, treatment, vertical transmission, and ocular toxoplasmosis. can also be used to study cutaneous and visceral leishmaniasis, as the animals present cutaneous lesions, as well as parasites in the organs. has epidemiological importance in Chagas disease, and since it is a natural host in which rodents show high parasitemia and lethality, they are also effective as a model of congenital transmission. In the study of schistosomiasis, was proven to be a natural host; thus, this rodent is a great model for fibrosis, hepatic granulomatous reaction, and celloma associated with lymphomyeloid tissue (CALT) during infection. In this review, we summarize the leading studies of parasitic diseases that used as a rodent experimental model, describing the main uses and characteristics that led them to be considered an effective model.
PubMed: 35335694
DOI: 10.3390/pathogens11030369 -
Journal of Ophthalmic Inflammation and... Sep 2022Uveitis is one of the common causes of visual impairment in Malaysia. It remains a challenging entity to diagnose and manage due to variation in its clinical...
INTRODUCTION
Uveitis is one of the common causes of visual impairment in Malaysia. It remains a challenging entity to diagnose and manage due to variation in its clinical presentation. This study aims to observe the demographic and clinical pattern of cases from the participating ophthalmology units in Malaysia.
METHODS
This study involved prospective and multicentered data collection for patients newly diagnosed with uveitis from 1 January 2018 to 31 December 2018. Variables collected and analyzed included age, gender, ethnicity, nationality, state of origin, laterality, granulomatous or non-granulomatous uveitis, and etiology of uveitis.
RESULTS
A total of 1199 newly diagnosed uveitis patients were analyzed within the study period. There was a significant association between the anatomical location of uveitis with age at presentation. The percentage of patients with anterior uveitis was higher in the '40 to 60' years and 'above 60' years age groups at 52.1% (n = 210) and 61.3% (n = 114) respectively. In contrast the percentage of patients with posterior and panuveitis was higher in the 1 to 20 and 20 to 40 years age groups at 51.4% (n = 54) and 48.7% (n = 246) respectively. Sixty three percent of the patients presented with unilateral uveitis (n = 760, p < 0.001) vs bilateral. Non-granulomatous uveitis comprised 84.5% of all patients (n = 1013, p < 0.001) compared to granulomatous uveitis. Non-infectious etiology contributed to 65.7% of all patients (n = 788, p < 0.001) with the majority being unclassifiable uveitis (n = 686, 57.2%,). Specific inflammatory entities contributed to only 8.5% (n = 102) of the non-infectious causes with Vogt-Koyanagi-Harada (VKH) syndrome being the most common (n = 25, 2.1%,). Infectious uveitis comprised 34.3% (n = 411) with tubercular (TB) uveitis (n = 105, 8.8%) and viral uveitis (n = 107, 8.9%) contributing the most followed by ocular Toxoplasmosis (n = 93,7.8%).] CONCLUSION: This study has highlighted the demographic data and common causes of uveitis in Malaysia.
PubMed: 36048269
DOI: 10.1186/s12348-022-00306-1 -
Iranian Journal of Immunology : IJI Sep 2019The diagnostic methods which are used for acute ocular toxoplasmosis are very important; if the treatment is delayed, it sometimes leads to loss of vision. Few studies...
BACKGROUND
The diagnostic methods which are used for acute ocular toxoplasmosis are very important; if the treatment is delayed, it sometimes leads to loss of vision. Few studies have been performed to evaluate serological tests used in the diagnosis of acute ocular toxoplasmosis.
OBJECTIVES
To evaluate the immunoglobulin (Ig) M, G and IgG avidity tests for diagnosis of acute ocular toxoplasmosis in the northeast of Iran.
METHODS
A cross-sectional study was carried out from January 2014 to December 2016. After an opthalmic examination was conducted by a retina specialist, 16 typical acute and 34 typical chronic ocular toxoplasmosis cases were included in this study. Information on clinical manifestations, age and occupation was recorded. Anti-Toxoplasma IgG, IgM and IgG avidity tests were administered on serum samples using the ELISA method.
RESULTS
Blurring of vision in all patients was the most clinical presentation. The IgG avidity test could diagnose all acute and recent cases. However, three false positive and one false negative result occurred using the IgM test by ELISA. The false negative result in all likelihood occurred because the patient was at the beginning stage of the infection.
CONCLUSION
The result of this study showed that IgM is not a reliable marker of acute disease. Repetition of the serology tests was proposed in cases with clinical manifestations without detectable antibody titer after approximately two weeks. IgG avidity testing results coincided with clinical diagnosis and it could therefore considered to be a reliable method to differentiate between recently acquired and chronic ocular toxoplasmosis.
Topics: Adult; Antibodies, Protozoan; Antibody Affinity; Cross-Sectional Studies; Female; Humans; Immunoglobulin G; Immunoglobulin M; Immunologic Tests; Iran; Male; Tertiary Care Centers; Toxoplasma; Toxoplasmosis, Ocular; Young Adult
PubMed: 31552834
DOI: 10.22034/IJI.2019.80276 -
Frontiers in Immunology 2023The particularities of the ocular immune environment and its barrier protection in the context of infection are not well elucidated. The apicomplexan parasite is one of...
INTRODUCTION
The particularities of the ocular immune environment and its barrier protection in the context of infection are not well elucidated. The apicomplexan parasite is one of the pathogens successfully crossing this barrier and establishing chronic infection in retinal cells.
METHODS
As a first approach, we studied the initial cytokine network in vitro in four human cell lines: Retinal pigmented epithelial (RPE), microglial, astrocytic and Müller cells. Furthermore, we looked at the consequences of retinal infection on the integrity of the outer blood-retina barrier (oBRB). We particularly focused on the roles of type I and type III interferons, (IFN-β and IFN-λ). Especially IFN-λ is known for its significant role in barrier defense. However, its effect on the retinal barrier or infection remains unexplored, unlike IFN-γ, which has been extensively studied in this context.
RESULTS AND DISCUSSION
Here, we show that stimulation with type I and III interferons did not limit parasite proliferation in retinal cells we tested. However, IFN-β and IFN-γ strongly induced inflammatory or cell-attracting cytokine production, whereas IFN-λ1 showed less inflammatory activity. Concomitant infection influenced these cytokine patterns, distinctly depending on the parasite strain. Interestingly, all these cells could be stimulated to produce IFN-λ1. Using an in vitro oBRB model based on RPE cells, we observed that interferon stimulation strengthened membrane localization of the tight junction protein ZO-1 and enhanced their barrier function, in a STAT1-independent manner.
CONCLUSION
Together, our model shows how infection shapes the retinal cytokine network and barrier function, and demonstrates the role of type I and type III interferons in these processes.
Topics: Humans; Interferons; Toxoplasmosis, Ocular; Cytokines; Retina; Toxoplasma
PubMed: 37205102
DOI: 10.3389/fimmu.2023.1148037 -
Medicina (Kaunas, Lithuania) Nov 2022: To investigate the etiology, clinical features, ocular complications, and visual outcomes in children with infectious uveitis referred to a tertiary uveitis...
: To investigate the etiology, clinical features, ocular complications, and visual outcomes in children with infectious uveitis referred to a tertiary uveitis hospital-based service. : Children with infectious uveitis were included in a retrospective cohort study. The data set was obtained after reviewing the medical records of pediatric patients with uveitis of different causes referred to our center during the period from 2009 to 2019. Clinical evaluations were performed at the time of diagnosis and the end of follow-up. : Uveitis of infectious origin was present in 57 (72 eyes) of 314 (18.1%) patients examined. The median age at presentation was 10.9 years (6.1-15.8), 52.6% of patients were female, and 47.4% were male. The main cause of infectious uveitis was viral (56.1% of cases), followed by Toxoplasma gondii infection (24.5%). The anatomical location of uveitis was posterior in 40.3%, anterior in 36.8%, panuveitis in 15.7%, and intermediate in 7% of cases. Ocular involvement was unilateral in 42 children (73.7%) and bilateral in 15 (26.3%) cases. The main causes of reduced visual acuity were cataract and maculopathy in 57.1% and 28.5% of cases, respectively. During the follow-up period, 75% of patients showed significant improvements in visual acuity. : Specialist management in a tertiary referral eye care center facilitates early diagnosis and effective treatment of this serious cause of morbidity and vision loss in children.
Topics: Child; Humans; Male; Female; Retrospective Studies; Uveitis; Referral and Consultation; Tertiary Care Centers; Visual Acuity
PubMed: 36422212
DOI: 10.3390/medicina58111673 -
American Journal of Ophthalmology Case... Sep 2021To report an unusual case of congenital bilateral abnormality due to coexisting ocular toxoplasmosis and retinopathy of prematurity.
PURPOSE
To report an unusual case of congenital bilateral abnormality due to coexisting ocular toxoplasmosis and retinopathy of prematurity.
OBSERVATIONS
A prematurely born baby with bilateral retinopathy of prematurity (ROP) (one eye treated) was found to have a hyperpigmented torpedo maculopathy lesion in one eye while the other eye presented with microphthalmia, congenital cataract and non-specific pigmentary retinopathy. Following negative TORCH screening, laboratory tests subsequently revealed increased plasma IgG and IgM for toxoplasmosis.
CONCLUSIONS
We present an unusual case of coexistence of congenital ocular toxoplasmosis with torpedo maculopathy and retinopathy of prematurity.
PubMed: 34095608
DOI: 10.1016/j.ajoc.2021.101121 -
La Tunisie Medicale Feb 2023Infectious uveitis (IU), one of the main causes of ocular inflammation in Tunisia, has various etiologies and clinical presentations. (Observational Study)
Observational Study
INTRODUCTION
Infectious uveitis (IU), one of the main causes of ocular inflammation in Tunisia, has various etiologies and clinical presentations.
AIM
To report the causes and clinical features of IU in a Tunisian population.
METHODS
Patients with IU referred to our department from February 2019 to January 2022 were included in a retrospective observational study. Ophthalmic examination and appropriate ancillary tests were performed.
RESULTS
Eighty eyes of 63 patients were included (37 female and 26 male). The mean age was 45 years. IU was unilateral in 43 cases, bilateral in 17, and unilateral alternating in three cases. Panuveitis was the most common anatomic location (35% of cases) followed by posterior (31%), anterior (18 eyes), intermediate (6 eyes) and anterior and intermediate uveitis (3 eyes). Non granulomatous uveitis (55%) occurred more frequently than granulomatous uveitis (45%). Etiologies were dominated by bacterial infections (29 patients; 46%), mainly tuberculosis (23 patients), followed by viruses (19 patients), mainly Herpes simplex virus. Fungal infection was found in one patient, while parasites accounted for 14 cases, mostly toxoplasmosis. Mean initial diagnostic delay was 16 months. The most common complications included occlusive retinal vasculitis (19 eyes), cataract (17 eyes), cystoid macular edema (17 eyes) and papilledema (15 eyes).
CONCLUSION
This study highlighted the causes and clinical features of IU in our setting. Tuberculosis remains one of its most frequent etiologies in Tunisia. However, a larger multicenter national study would allow a more precise evaluation.
Topics: Humans; Female; Male; Middle Aged; Delayed Diagnosis; Uveitis; Eye Infections, Bacterial; Panuveitis; Cataract
PubMed: 37682270
DOI: No ID Found