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Allergy & Immunology1092 papers

Toxoplasmosis

Last edited: 4/14/2026

Overview

Toxoplasmosis, caused by Toxoplasma gondii, is a zoonotic disease affecting humans and animals, posing significant risks to pregnant women and immunocompromised individuals through congenital transmission and severe systemic complications 127.

Diagnosis

  • Serological tests (IgM, IgG) for antibody detection 101522
  • Molecular tests (PCR) for confirmation in ocular and systemic infections 6
  • Imaging (MRI, CT) for neurological and ocular manifestations 4924
  • Histopathological examination for definitive diagnosis in tissue samples 828

    • Management

  • First-line treatments:
    • - Pyrimethamine + Sulfadiazine + Folinic acid (Leucovorin) 5
  • Adjunctive therapies:
    • - Corticosteroids for severe inflammation or ocular involvement 13 - Antiepileptic drugs if seizures occur 12

    Special Populations

  • Pregnancy:
    • - Routine screening for IgG and IgM antibodies 71116 - Prophylactic measures to prevent maternal infection 17
  • Immunocompromised:
    • - Close monitoring for disseminated disease 812 - Extended and possibly higher dose treatment regimens 5
  • Elderly and Pediatrics:
    • - Increased vigilance for neurological and ocular complications 424 - Tailored treatment based on severity and organ involvement 112

    Key Recommendations

  • Screen pregnant women for Toxoplasma gondii antibodies to prevent congenital transmission (Evidence: Strong 71116)
  • Initiate combination therapy with pyrimethamine, sulfadiazine, and folinic acid for severe or disseminated toxoplasmosis (Evidence: Moderate 5)
  • Consider prophylactic measures and education for pregnant women to reduce risk of infection (Evidence: Expert opinion 17)
  • Regular ophthalmologic evaluation for patients with ocular toxoplasmosis to monitor for complications like retinochoroiditis (Evidence: Moderate 1318)
  • Use serological and molecular tests in conjunction for accurate diagnosis of acute versus chronic infection (Evidence: Moderate 106)

    • References

    1 Foroutan M, Karimzadeh-Soureshjani E, Ghaffarifar F. Is Toxoplasma gondii-secreted Protein With an Altered Thrombospondin Repeat (TgSPATR) a Potential Candidate for Immunisation? An Immunoinformatics-Based Analysis. Veterinary medicine and science 2026. link 2 Asadi M, Ghaffari AD, Mohammadhasani F. In silico analysis and structural vaccinology prediction of Toxoplasma gondii ROP41 gene via immunoinformatics methods as a vaccine candidate. Current research in translational medicine 2025. link 3 Majidiani H, Pourseif MM, Kordi B, Sadeghi MR, Najafi A. TgVax452, an epitope-based candidate vaccine targeting Toxoplasma gondii tachyzoite-specific SAG1-related sequence (SRS) proteins: immunoinformatics, structural simulations and experimental evidence-based approaches. BMC infectious diseases 2024. link 4 Filipowicz A, Coca MN, Blair BM, Chang PY. ACUTE MYOCARDITIS WITH CARDIOGENIC SHOCK AND MULTIPLE ORGAN FAILURE, FOLLOWED BY BILATERAL PANUVEITIS MASQUERADING AS ENDOGENOUS ENDOPHTHALMITIS, DUE TO TOXOPLASMA GONDII IN AN IMMUNOCOMPETENT PATIENT. Retinal cases & brief reports 2021. link 5 Shammaa AM, Powell TG, Benmerzouga I. Adverse outcomes associated with the treatment of Toxoplasma infections. Scientific reports 2021. link 6 Murata FHA, Previato M, Frederico FB, Barbosa AP, Nakashima F, de Faria GM et al.. Evaluation of Serological and Molecular Tests Used for the Identification of . Frontiers in cellular and infection microbiology 2019. link 7 Paquet C, Yudin MH. No. 285-Toxoplasmosis in Pregnancy: Prevention, Screening, and Treatment. Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2018. link 8 Cortés AD, Aguirre N. Severe disseminated acute toxoplasmosis in an adult immunocompetent patient from the Colombian Pacific. Biomedica : revista del Instituto Nacional de Salud 2018. link 9 Kumar V, Takkar B, Chandra P, Kumar A. Macular infarction in a patient with Toxoplasma retinochoroditis. BMJ case reports 2016. link 10 Costa JG, Duré AB. Immunochemical evaluation of two Toxoplasma gondii GRA8 sequences to detect acute toxoplasmosis infection. Microbial pathogenesis 2016. link 11 Davis SM, Anderson BL, Schulkin J, Jones K, Vanden Eng J, Jones JL. Survey of obstetrician-gynecologists in the United States about toxoplasmosis: 2012 update. Archives of gynecology and obstetrics 2015. link 12 Undseth Ø, Gerlyng P, Goplen AK, Holter ES, von der Lippe E, Dunlop O. Primary toxoplasmosis with critical illness and multi-organ failure in an immunocompetent young man. Scandinavian journal of infectious diseases 2014. link 13 Kim SJ, Scott IU, Brown GC, Brown MM, Ho AC, Ip MS et al.. Interventions for toxoplasma retinochoroiditis: a report by the American Academy of Ophthalmology. Ophthalmology 2013. link 14 Jiang S, Hua E, Liang M, Liu B, Xie G. A novel immunosensor for detecting toxoplasma gondii-specific IgM based on goldmag nanoparticles and graphene sheets. Colloids and surfaces. B, Biointerfaces 2013. link 15 Singh S, Khang TF, Andiappan H, Nissapatorn V, Subrayan V. An age-adjusted seroprevalence study of Toxoplasma antibody in a Malaysian ophthalmology unit. Transactions of the Royal Society of Tropical Medicine and Hygiene 2012. link 16 Jones JL, Krueger A, Schulkin J, Schantz PM. Toxoplasmosis prevention and testing in pregnancy, survey of obstetrician-gynaecologists. Zoonoses and public health 2010. link 17 Kravetz JD, Federman DG. Prevention of toxoplasmosis in pregnancy: knowledge of risk factors. Infectious diseases in obstetrics and gynecology 2005. link 18 Lum F, Jones JL, Holland GN, Liesegang TJ. Survey of ophthalmologists about ocular toxoplasmosis. American journal of ophthalmology 2005. link 19 Tvaryanas AP. Case from the aerospace medicine residents' teaching file. Chorioretinitis due to toxoplasmosis. Aviation, space, and environmental medicine 2003. link 20 Jones JL, Dietz VJ, Power M, Lopez A, Wilson M, Navin TR et al.. Survey of obstetrician-gynecologists in the United States about toxoplasmosis. Infectious diseases in obstetrics and gynecology 2001. link 21 Payling K. Toxoplasmosis and pregnant women. Professional nurse (London, England) 1995. link 22 Safar EH, Abd-el Ghaffar FM, Saffar SA, Makled KM, Habib KS, el Abiad R et al.. Incidence of Toxoplasma and Toxocara antibodies among out-patients in the Ophthalmic Research Institute, Egypt. Journal of the Egyptian Society of Parasitology 1995. link 23 el-Fakahany AF, Abdalla KF, Younis MS, Hassan OA, el-Shantoury M. Tonsilar toxoplasmosis. Journal of the Egyptian Society of Parasitology 1992. link 24 Rekhi GS, Sharma DP, Sharma P, Prabhakar G. Toxoplasmic retinochoroiditis and hydrocephalus. Indian journal of ophthalmology 1991. link 25 Natu M, Joshi BN, Sali N. Toxoplasmosis prevalence in pregnancy with bad obstetric history. Indian journal of medical sciences 1989. link 26 Sheibani K, Fritz RM, Winberg CD, Burke JS, Rappaport H. "Monocytoid" cells in reactive follicular hyperplasia with and without multifocal histiocytic reactions: an immunohistochemical study of 21 cases including suspected cases of toxoplasmic lymphadenitis. American journal of clinical pathology 1984. link 27 Partanen P, Turunen HJ, Paasivuo R, Forsblom E, Suni J, Leinikki PO. Identification of antigenic components of Toxoplasma gondii by an immunoblotting technique. FEBS letters 1983. link80589-4) 28 Tiwari I, Rolland CF, Popple AW. Cholestatic jaundice due to toxoplasma hepatitis. Postgraduate medical journal 1982. link 29 Mas Bakal P, in 't Veld N, Piekarski G. Investigation into the occurrence of toxoplasma in pharyngeal and palatine tonsils by inoculation of tonsillar tissues into mice. Infection 1979. link 30 Räisänen S. Toxoplasmosis transmitted by blood transfusions. Transfusion 1978. link 31 Uchida Y, Kakehashi Y, Kameyama K. Juxtapapillary retinochoroiditis with a psychiatric disorder possibly caused by toxoplasma. American journal of ophthalmology 1978. link90122-8) 32 Schulhof LA, Russell JR. Intracerebral toxoplasmosis presenting as a mass lesion. Surgical neurology 1975. link

    Original source

    1. [1]
      Is Toxoplasma gondii-secreted Protein With an Altered Thrombospondin Repeat (TgSPATR) a Potential Candidate for Immunisation? An Immunoinformatics-Based Analysis. — Foroutan M, Karimzadeh-Soureshjani E, Ghaffarifar F Veterinary medicine and science (2026)
    2. [2]
      In silico analysis and structural vaccinology prediction of Toxoplasma gondii ROP41 gene via immunoinformatics methods as a vaccine candidate. — Asadi M, Ghaffari AD, Mohammadhasani F Current research in translational medicine (2025)
    3. [3]
      TgVax452, an epitope-based candidate vaccine targeting Toxoplasma gondii tachyzoite-specific SAG1-related sequence (SRS) proteins: immunoinformatics, structural simulations and experimental evidence-based approaches. — Majidiani H, Pourseif MM, Kordi B, Sadeghi MR, Najafi A BMC infectious diseases (2024)
    4. [4]
      ACUTE MYOCARDITIS WITH CARDIOGENIC SHOCK AND MULTIPLE ORGAN FAILURE, FOLLOWED BY BILATERAL PANUVEITIS MASQUERADING AS ENDOGENOUS ENDOPHTHALMITIS, DUE TO TOXOPLASMA GONDII IN AN IMMUNOCOMPETENT PATIENT. — Filipowicz A, Coca MN, Blair BM, Chang PY Retinal cases & brief reports (2021)
    5. [5]
      Adverse outcomes associated with the treatment of Toxoplasma infections. — Shammaa AM, Powell TG, Benmerzouga I Scientific reports (2021)
    6. [6]
      Evaluation of Serological and Molecular Tests Used for the Identification of — Murata FHA, Previato M, Frederico FB, Barbosa AP, Nakashima F, de Faria GM et al. Frontiers in cellular and infection microbiology (2019)
    7. [7]
      No. 285-Toxoplasmosis in Pregnancy: Prevention, Screening, and Treatment. — Paquet C, Yudin MH Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC (2018)
    8. [8]
      Severe disseminated acute toxoplasmosis in an adult immunocompetent patient from the Colombian Pacific. — Cortés AD, Aguirre N Biomedica : revista del Instituto Nacional de Salud (2018)
    9. [9]
      Macular infarction in a patient with Toxoplasma retinochoroditis. — Kumar V, Takkar B, Chandra P, Kumar A BMJ case reports (2016)
    10. [10]
      Immunochemical evaluation of two Toxoplasma gondii GRA8 sequences to detect acute toxoplasmosis infection. — Costa JG, Duré AB Microbial pathogenesis (2016)
    11. [11]
      Survey of obstetrician-gynecologists in the United States about toxoplasmosis: 2012 update. — Davis SM, Anderson BL, Schulkin J, Jones K, Vanden Eng J, Jones JL Archives of gynecology and obstetrics (2015)
    12. [12]
      Primary toxoplasmosis with critical illness and multi-organ failure in an immunocompetent young man. — Undseth Ø, Gerlyng P, Goplen AK, Holter ES, von der Lippe E, Dunlop O Scandinavian journal of infectious diseases (2014)
    13. [13]
      Interventions for toxoplasma retinochoroiditis: a report by the American Academy of Ophthalmology. — Kim SJ, Scott IU, Brown GC, Brown MM, Ho AC, Ip MS et al. Ophthalmology (2013)
    14. [14]
      A novel immunosensor for detecting toxoplasma gondii-specific IgM based on goldmag nanoparticles and graphene sheets. — Jiang S, Hua E, Liang M, Liu B, Xie G Colloids and surfaces. B, Biointerfaces (2013)
    15. [15]
      An age-adjusted seroprevalence study of Toxoplasma antibody in a Malaysian ophthalmology unit. — Singh S, Khang TF, Andiappan H, Nissapatorn V, Subrayan V Transactions of the Royal Society of Tropical Medicine and Hygiene (2012)
    16. [16]
      Toxoplasmosis prevention and testing in pregnancy, survey of obstetrician-gynaecologists. — Jones JL, Krueger A, Schulkin J, Schantz PM Zoonoses and public health (2010)
    17. [17]
      Prevention of toxoplasmosis in pregnancy: knowledge of risk factors. — Kravetz JD, Federman DG Infectious diseases in obstetrics and gynecology (2005)
    18. [18]
      Survey of ophthalmologists about ocular toxoplasmosis. — Lum F, Jones JL, Holland GN, Liesegang TJ American journal of ophthalmology (2005)
    19. [19]
      Case from the aerospace medicine residents' teaching file. Chorioretinitis due to toxoplasmosis. — Tvaryanas AP Aviation, space, and environmental medicine (2003)
    20. [20]
      Survey of obstetrician-gynecologists in the United States about toxoplasmosis. — Jones JL, Dietz VJ, Power M, Lopez A, Wilson M, Navin TR et al. Infectious diseases in obstetrics and gynecology (2001)
    21. [21]
      Toxoplasmosis and pregnant women. — Payling K Professional nurse (London, England) (1995)
    22. [22]
      Incidence of Toxoplasma and Toxocara antibodies among out-patients in the Ophthalmic Research Institute, Egypt. — Safar EH, Abd-el Ghaffar FM, Saffar SA, Makled KM, Habib KS, el Abiad R et al. Journal of the Egyptian Society of Parasitology (1995)
    23. [23]
      Tonsilar toxoplasmosis. — el-Fakahany AF, Abdalla KF, Younis MS, Hassan OA, el-Shantoury M Journal of the Egyptian Society of Parasitology (1992)
    24. [24]
      Toxoplasmic retinochoroiditis and hydrocephalus. — Rekhi GS, Sharma DP, Sharma P, Prabhakar G Indian journal of ophthalmology (1991)
    25. [25]
      Toxoplasmosis prevalence in pregnancy with bad obstetric history. — Natu M, Joshi BN, Sali N Indian journal of medical sciences (1989)
    26. [26]
      "Monocytoid" cells in reactive follicular hyperplasia with and without multifocal histiocytic reactions: an immunohistochemical study of 21 cases including suspected cases of toxoplasmic lymphadenitis. — Sheibani K, Fritz RM, Winberg CD, Burke JS, Rappaport H American journal of clinical pathology (1984)
    27. [27]
      Identification of antigenic components of Toxoplasma gondii by an immunoblotting technique. — Partanen P, Turunen HJ, Paasivuo R, Forsblom E, Suni J, Leinikki PO FEBS letters (1983)
    28. [28]
      Cholestatic jaundice due to toxoplasma hepatitis. — Tiwari I, Rolland CF, Popple AW Postgraduate medical journal (1982)
    29. [29]
      Investigation into the occurrence of toxoplasma in pharyngeal and palatine tonsils by inoculation of tonsillar tissues into mice. — Mas Bakal P, in 't Veld N, Piekarski G Infection (1979)
    30. [30]
      Toxoplasmosis transmitted by blood transfusions. — Räisänen S Transfusion (1978)
    31. [31]
      Juxtapapillary retinochoroiditis with a psychiatric disorder possibly caused by toxoplasma. — Uchida Y, Kakehashi Y, Kameyama K American journal of ophthalmology (1978)
    32. [32]
      Intracerebral toxoplasmosis presenting as a mass lesion. — Schulhof LA, Russell JR Surgical neurology (1975)
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