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Current options for the diagnosis and therapy of toxoplasmosis in HIV-negative patients

Publication at Faculty of Medicine in Hradec Králové |
2009

Abstract

Toxoplasmosis is serious disease in immunocompromised patiens, pregnant women, newborns and patiens with ocular forms of toxoplasmosis. The standard therapeutic regimen is an combination of pyrimethamine and sulfadiazine.

In pregnant women this regimen is initiated during the week 15 of gestation, until then spiramicine is the treatment of choice. Newborns, congenital infection is treated by the standard therapeutic regiment, which can be given in alterance courses of spiramycine.

Treatment of ocular forms are usually consist of the standard regimen as well, but the sulfadiazine can be substituted by clindamicine. The treatment in the immunocompromised patiens is the standard combination of pyrimethamine and sulfadiazine, however, alternative treatments has to be substituted.

In some patiens primary profylaxis of cerebral toxoplasmosis is achieved by cotrimoxazole. Reduced dosing of the standard regimen can be used as secondary profylaxis in these patiens during severe immunosuppression.