How likely is it for an individual to be suffering from toxoplasmosis,
even though the blood analysis suggests that antibodies are present
and the doctor thinks an infection must have taken place (and gone
unnoticed at the time) many years back? If indeed people can have toxo
twice (once unnoticed and some years later acutely), what would this
mean for the second blood test? Are there alternative testing methods
that are not based on blood samples, e.g. tissue samples from swollen
lymph nodes?Hi cmo,
Let?s address the issue of getting toxoplasmosis twice, first. No, you
don?t get toxoplasmosis twice. Once you are exposed to Toxoplasma
gondii, your body produces antibodies to the parasite. These
antibodies protect you for life against a recurrence (recrudescence)
of T.gondii infection. You will be immune forever. The caveat is, if
you should become immuno-compromised later in life, by being on
chemotherapy, or developing HIV, you may be prone to developing
encephalitis (brain infection of T. gondii)
http://www.drjick.com/toxo2.php
Your doctor is correct, if you have a positive antibody test now, it
may indeed mean you had the infection previously. Depending on which
test you had, it may also mean you have it now, and something else
previously! Generally though, the titer rises during current
infection, and lowers during recovery. There is a good algorithm for
the antibody test on the page that is linked at the end of the next
paragraph.
If you are currently infected, your results will show: IgG positive
and IgM positive, with low IgG avidity. If you were previously
infected, your results would show IgG positive, and IgM negative, and
a high IgG avidity. (Avidity describes how strong the antibody binds
to the T.gondii organism)
http://www.dpd.cdc.gov/dpdx/HTML/Toxoplasmosis.asp?body=Frames/S-Z/Toxoplasmosis/body_Toxoplasmosis_serol1.htm
?After you're infected with T. gondii, the parasite forms cysts that
can affect almost any organ but that most often affect your brain,
skeleton and heart muscle. If you're generally healthy, your immune
system keeps the parasites at bay, and they remain in your body in an
inactive state for life. This provides immunity so that you can't
become infected with the parasite again. But if your resistance is
weakened by disease or certain medications, the infection can be
reactivated, leading to serious complications.?
http://www.cnn.com/HEALTH/library/DS/00510.html
T. gondii is an interesting parasitic infection, affecting about 30%
of Americans and British, and up to 65% of the French (due to eating
more uncooked and undercooked meat). T. gondii is something most
people never think of, yet is is a serious concern to pregnant women
and those with a compromised immune system. Should a pregnant woman
contract T.gondii, she can suffer miscarriage, or give birth to a
child with mental retardation, cerebral palsy, and/or serious eye and
ear problems. The good news, if you can call it that, is T.gondii is
not transmitted human to human.
T.gondii reproduces in the intestines of cats, and is shed in cat
feces, turning up in yard soil, and kitty litter boxes. Most people do
not exhibit any symptoms, and if one is asymptomatic, need no therapy.
If symptoms present, the patient is usually treated with pyrimethamine
and either trisulfapyrimidines or sulfadiazine. Some times clindamycin
is given, as an alternative drug. Pregnant women are treated with
spiramycin.
T.gondii is diagnosed in several ways:
Blood tests to detect the T.gondii antibody is the most common
method. The test should not be drawn until about 3 weeks following
exposure/symptoms. If the blood is drawn too early, the quantity of
blood antibodies present is too small to be detected, and may give a
false negative.The most accurate way to get a good set of results it
to have one sample drawn at 3 weeks post infection. This sample should
be processed and frozen, until the second sample is drawn, 2-3 weeks
later. Then BOTH samples should be sent to the lab and run together.
This eliminates testing variances in labs, reagents, method, humidity,
and technical bias. Some labs have a newer test that detects the
presence of the organism itself, and not just the antibody. The PCR
test, sometimes used to test for T. gondii, can?t distinguish between
current and past infection, and this may be the kind you had.
If you are seriously interested in having your blood tested, suggest
that your doctor order a TSP (Toxoplasma Serological Profile) With
this panel, you?ll get what we used to call ?The Works?! ?Recently,
several tests for avidity of toxoplasma IgG antibodies have been
introduced to help discriminate between recently acquired and distant
infection. Studies of the kinetics of the avidity of IgG in pregnant
women who have seroconverted during gestation have shown that women
with high avidity test results were infected with T. gondii at least 3
to 5 months earlier (time to conversion from low to high avidity
antibodies varies with the method used). Because low avidity
antibodies may persist for many months, their presence does not
necessarily indicate recently acquired infection.?
http://www.pamf.org/serology/clinicianguide.html#toxosero
A tissue biopsy or spinal fluid culture can find the organism, but are
more painful methods, and not as sensitive as the blood tests. Often
these methods are used at autopsy.
A needle biopsy can be employed for T.gondii. The needle has a bore
width adequate to take a ?plug? of muscle, which is examined under a
microscope for parasites. To collect CSF (cerebral spinal fluid) for
culture, a lumbar puncture (spinal tap) will be performed.
http://www.nlm.nih.gov/medlineplus/ency/article/003924.htm
Diagnostic imaging, such as MRI, CAT, ultrasound or X-rays can
visualize if any parasites have made their way to the brain, heart or
organs.
http://my.webmd.com/hw/hiv_aids/hw5932.asp
?A positive antibody test, on the other hand, doesn't necessarily mean
you're actively infected. In many cases, it's a sign that you were
infected at some time in your life and are now immune to the disease.
Further tests can help determine when the infection occurred, based on
the types of antibodies in your blood, and whether the levels of these
antibodies are rising or falling. This is especially important if
you're pregnant or living with HIV/AIDS.?
http://www.ecureme.com/emyhealth/data/Toxoplasmosis.asp
?The most common method of detecting Toxoplasma infection is through
antibody testing. Blood tests detect the presence of antibodies to the
Toxoplasma parasite called IgG or IgM. Positive IgG indicates past
exposure and is evidence of immunity. Positive IgM is supposed to
indicate current infection, but there have been problems with
commercial testing for IgM resulting in a high level of
false-positives. Universal screening is not practiced in the U.S.?
http://www.drjick.com/toxo2.php
This page has several pictures of T.gondii. Click the thumbnail
picture to see the enlarged version. The tachyzoites are particularly
cute, and somewhat resemble malarial parasites!
http://www.dpd.cdc.gov/dpdx/HTML/ImageLibrary/Toxoplasmosis_il.htm
I wish I had found this site first, and not last. It covers ALL your
questions! You can also see the life cycle of T.gondii parasites.
(Warning-there is a graphic picture of a baby born with hydrocephalus
caused by T.gondii.)
http://www.modares.ac.ir/elearning/Dalimi/Proto/Lectures/week10.htm
Additional information:
http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/24704.html
I hope this has answered your questions. If not, or if I have
duplicated information you already had, please request an Answer
Clarification, before rating. This will enable me to assist you
further, if possible.
Regards,
crabcakes
Search Terms
T.gondii antibody
Recurrence toxoplasmosis
Serological tests t.gondii
Diagnosing t.gondiiHi again;
first I should warn you that I am not a medical professional, the
reason I know this is because I've had a somewhat similar problem
myself.
CO-Trimoxazole can cause irreversible liver and kidney damage, but
this is rare. There are also multiple other side-effects, you can read
more on the pages below:
http://www.rxlist.com/cgi/generic/trisulf_ad.htm
http://www.netdoctor.co.uk/medicines/showpreparation.asp?id=617
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202781.html
I am not sure what would be "easier to misinterpret"; it depends upon
the bodys immune response and the quality of tests avaliable.
Chlamydia pneumoniae/TWAR can be hard to catch, while EBV (if I
remember correctly) produces antibodies that lasts a lifetime.
:-)Thanks, Arsenic! I must now assume that the CO-Trimoxazole is showing
some effect, because after 4 weeks of being stagnant (and after one
week of starting on CO-Trimoxazole) my lymph node swelling has
decreased a lot. "Strangely"(?!), this is happening right at the end
of the first course of antibiotics. This development is fairly new -
it started at 3pm yesterday and then things progressed by the hour. I
was quite amazed! The test results are due out later, but despite the
fact that I am happy that things are getting better, I am still
curious to learn what happened.
My assumption is that 9 months ago I was routinely given antibiotics,
which did part of the job, but when the (potentially wrong) blood
tests came back a virus was assumed. That's why I got taken off
antibiotics. My layman's assumption is that is indeed it WASN'T a
virus, then stopping antibiotics early meant that the cause wasn't
eradicated completely, giving me all kinds of trouble over the last 9
months.
If anybody reading this knows the answer to the following question, I
would love to hear it: assuming one has an unidentified bacteria (or
parasite) that CO-Trimoxazole can successfully cure, how long would a
medication treatment be necessary for the organism to be completely
gone? I am just trying to avoid for this stuff to "come back and haunt
me" again... Thanks!Antibiotics will unfortunately not work on CMV or EBV, since they are
virii. CO-Trimoxazole will cure toxoplasmosis along with many
bacterial infections; but the drug has bad side-effects, so it may do
more harm than good if it turns out it's not toxo.
I hope you will get an answer to what's wrong, and I hope you get better soon!Thanks, but that was (initially, meaning 9 months ago) also ruled out.
There is a new blood test "in the making", so that could bring some
new results now. I am puzzled anyway. For the time being, I have been
put on CO-Trimoxazole, and that seems at least to have reduced the
size of the lymph node, even if only little. Would anyone happen to
know if this antibiotic will work on ALL the possible options, e.g.
toxo, CMV, EBV, etc.?Make sure you have been tested for Cytomegalovirus (CMV) antibodies;
the symptoms match.
:) TlArsenic - what side effects are you referring to??? ;-( Thanks!Hi cmo,
This page will tell you about Co-trimoxazole, commonly known as Septra
or Bactrim in the US. Most courses of antibiotic therapy run 10 days,
but it depends on the strength of the tablet and your doctors orders.
It is very important to complete all of the medication. Many times,
patients begin to feel better, and discontinue their medication. By
doing so, the weaker organisms are wiped out, leaving the stronger,
resistant organisms to multiply, resulting in a superinfection.
http://www.inhousedrugstore-europe.com/infections/bactrim-information-patients.html
Regards,
crabcakesThanks, Crabcakes - I appreciate your comment. As I said, I am a
layman in the field of medicine, but what you said is EXACTLY what I
was worried about. I'll query the doctor on this when I call him later
today.Sorry, Arsenic, I should have known the virus vs. bacteria thing
regarding antibiotics. Maybe my brain is already suffering from
CO-Trimoxazole side effects ;-) But another question came to my mind,
though: when this whole thing started nine months ago, what would have
been "easier to misinterpret" - virus or bacteria? Or asked
differently: are blood tests more accurate on viruses or are they more
accurate on bacteria?The answer is very comprehensive, indeed. Thank you. Unfortunately, it
is not what I wanted to hear, since I am having all symptoms of an
acute toxoplasmosis (swollen lymph node(s), fatigue, etc. - no pain
though). As the blood test says it can't be toxo, then what else is
it? I might ask a follow-up question on this forum in a few days, when
the result of the needle biopsy that was done yesterday is awailable.
Things are a bit mysterious, since all other possibilities
(mononucleosis, HIV, Dengue [I live in the tropics], etc.) have also
been ruled out. A strange "virus infection" (as it was - maybe wrongly
- diagnosed then) started things off 9 months ago. Colds, sinusitis,
etc. followed, and I took all this as separate incidents, until the
swollen lymph node now makes me wonder if all of this could be one
single incident... Thanks again for a good overview!#If you have any other info about this subject , Please add it free.# |
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8 January 2009 |
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