Toxoplasmóza u imunokompromitovaných pacientů
[Toxoplasmosis in immunocompromised patients]
Language Czech Country Czech Republic Media print
Document type Journal Article, Review
PubMed
26099608
PII: 52442
- MeSH
- Anti-Infective Agents therapeutic use MeSH
- Immunocompromised Host * MeSH
- Trimethoprim, Sulfamethoxazole Drug Combination therapeutic use MeSH
- Humans MeSH
- Polymerase Chain Reaction MeSH
- Serologic Tests MeSH
- Toxoplasma genetics immunology isolation & purification MeSH
- Toxoplasmosis * diagnosis drug therapy parasitology MeSH
- Hematopoietic Stem Cell Transplantation adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Names of Substances
- Anti-Infective Agents MeSH
- Trimethoprim, Sulfamethoxazole Drug Combination MeSH
In humans, toxoplasmosis mostly occurs as a latent infection, but in immunocompromised individuals, the agent may reactivate and cause severe to life-threatening disease. HIV positive individuals and transplant recipients, in particular hematopoietic stem cell transplant and heart transplant recipients, are at highest risk. The disease most often affects the central nervous system but can involve any organ. Because of the alteration of the immune response in these patients, the serodiagnosis is not reliable and direct detection of the causative agent is needed--namely by microscopy and DNA PCR. If inadequately treated or left untreated, toxoplasmosis generally has a fatal prognosis in immunocompromised patients and therefore, the treatment must be started as early and energetically as possible. The gold standard both in the treatment of reactivation and secondary prophylaxis is the pyrimethamine-sulfadiazine combination while co-trimoxazole can be used in the primary prophylaxis for high-risk patients.