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Epidemiology, pathophysiology, diagnosis, and management of cerebral toxoplasmosis

Elsheikha, Hany M.; Marra, Christina M.; Zhu, Xing-Quan

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Authors

Christina M. Marra

Xing-Quan Zhu



Abstract

Toxoplasma gondii is known to infect a considerable number of mammalian and avian species and a substantial proportion of the world’s human population. The parasite has an impressive ability to disseminate within the host’s body and employs various tactics to overcome the highly regulatory blood-brain barrier and reside in the brain. In healthy individuals, T. gondii infection is largely tolerated without any obvious ill effects. However, primary infection in immunosuppressed patients can result in acute cerebral or systemic disease, and reactivation of latent tissue cysts can lead to a deadly outcome. It is imperative that treatment of life-threatening toxoplasmic encephalitis is timely and effective. Several therapeutic and prophylactic regimens have been used in clinical practice. Current approaches can control infection caused by the invasive and highly proliferative tachyzoites but cannot eliminate the dormant tissue cysts. Adverse events and other limitations are associated with the standard pyrimethamine-based therapy, and effective vaccines are unavailable. In this review, the epidemiology, economic impact, pathophysiology, diagnosis, and management of cerebral toxoplasmosis are discussed, and critical areas for future research are highlighted.

Citation

Elsheikha, H. M., Marra, C. M., & Zhu, X. (2020). Epidemiology, pathophysiology, diagnosis, and management of cerebral toxoplasmosis. Clinical Microbiology Reviews, 34(1), https://doi.org/10.1128/CMR.00115-19

Journal Article Type Review
Acceptance Date Oct 19, 2020
Online Publication Date Nov 25, 2020
Publication Date Nov 25, 2020
Deposit Date Nov 28, 2020
Publicly Available Date Mar 29, 2024
Journal Clinical Microbiology Reviews
Print ISSN 0893-8512
Electronic ISSN 1098-6618
Publisher American Society for Microbiology
Peer Reviewed Peer Reviewed
Volume 34
Issue 1
DOI https://doi.org/10.1128/CMR.00115-19
Keywords Public Health, Environmental and Occupational Health; Microbiology (medical); General Immunology and Microbiology; Epidemiology; Infectious Diseases
Public URL https://nottingham-repository.worktribe.com/output/5088461
Publisher URL https://cmr.asm.org/content/34/1/e00115-19

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