Toxoplasmosis – Diagnosis and Treatment
Diagnosis
Signs In The Eyes
When someone shows eye-related problems, a medical eye doctor, also called an ophthalmologist, often performs a full eye exam. The doctor uses special lenses and cameras to look closely at parts inside the eye.
The doctor checks for spots, swelling, or damage caused by Toxoplasma gondii. Blurred vision, eye pain, or visible lesions can be warning signs.
If the doctor suspects eye toxoplasmosis, they may order extra testing, including imaging or sampling fluids from the eye.
Symptoms Affecting The Brain Or Nervous System
If a person with toxoplasmosis has headaches, seizures, confusion, or other nervous system symptoms, doctors order further testing. Below is a summary of common diagnostic methods:
| Test Type | What It Detects | Why It Is Used |
|---|---|---|
| MRI or CT Scan | Abnormal areas in the brain caused by cysts or swelling | To check for brain inflammation or damage. |
| CSF Testing | T. gondii in spinal fluid | To confirm brain infection. |
| Brain Biopsy | Parasite in removed tissue (rarely done) | If diagnosis is very unclear. |
Lab technicians look for antibodies or DNA from the parasite in blood or spinal fluid. Testing plays a key role for people with HIV/AIDS or other conditions that weaken the immune system, who have a higher risk of brain infections.
Checking During Pregnancy
Doctors in the United States do not routinely screen pregnant women for toxoplasmosis. However, if a pregnant woman has possible symptoms, an antibody blood test can show if she has a new or past infection.
Sometimes results are unclear or a fetus shows signs of possible problems on an ultrasoundโa doctor may then collect a small sample of amniotic fluid.
Amniocentesis uses a thin needle to take this fluid. PCR tests look for genetic material of T. gondii in that fluid to check for fetal infection. If there is a high risk or unclear antibody results, this approach helps diagnose congenital toxoplasmosis.
Testing Babies Who May Be Infected
If doctors think a newborn was infected before birth, they order a series of tests soon after birth. Doctors check for the parasite through:
- Blood tests showed parasite antibodies.
- Brain imaging, like CT or ultrasound, to find signs of cysts, swelling, or injuries.
- Spinal fluid testing to look for infection.
- Eye exams for lesions or scarring.
- Hearing tests to see if an infection has affected hearing.
- Electroencephalogram (EEG) to watch for seizures or brain changes.
Treatment
Treatment Plans for Newborns
Infants with active infection often need specific medicine combinations for up to 1 or 2 years. Doctors closely track growth and health. They check for medicine side effects, vision changes, and delays in learning or movement.
Treatment commonly involves a combination of antiparasitic and antibiotic agents designed to target the infection and reduce inflammation. A folic acid derivative may be included to help protect healthy cells and reduce the risk of side effects such as bone marrow suppression.
In some cases, additional antimicrobial agents with activity against the parasite may be used depending on the patient’s response or tolerance to first-line options.
Extra Steps for Eye Problems
When the eyes are affected, treatment may also include anti-inflammatory medicine called glucocorticosteroids.
These drugs help reduce swelling and protect vision. Patients still take infection medicine along with these steroids, as recommended by their doctor.
Getting Ready for Your Visit
Before your appointment, gather information about any recent symptoms, including when they started, how long they have lasted, and how severe they are. Note whether the symptoms have been constant or come and go, and if anything seems to make them better or worse.
Make a complete list of all prescription medications, over-the-counter drugs, herbal remedies, vitamins, and supplements you are taking. Be sure to include dosage and frequency. This helps your provider avoid drug interactions and understand any medications that might affect your immune system.
Be ready to discuss any possible exposure risks, such as contact with cat litter, consuming raw or undercooked meats, gardening without gloves, or travel to areas with poor food hygiene.
What the Doctor May Ask
Doctors will gather as much information as possible to evaluate your condition. During your visit, they may ask:
- Have you had any recent flu-like symptoms such as fever, muscle aches, or swollen lymph nodes?
- Have you noticed changes in vision, headaches, or confusion?
- Are you pregnant or planning to become pregnant?
- Do you have any conditions that affect your immune system?
- Do you have a cat at home, and if so, who changes the litter?
- Have you eaten raw or undercooked meat, seafood, or unpasteurized dairy recently?
- Do you spend time gardening, and do you use gloves?
Answering these questions clearly helps your provider decide which tests to order and how to manage your care. Being honest and prepared helps your provider give the best care. Bringing a support person or writing down instructions during the visit can also help you remember the next steps more clearly.
