PEDIATRICS Vol. 65 No. 4 April 1980, pp. 706-712
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An Outbreak of Toxoplasmosis Linked to Cats

Sergio Stagno MD1, Aubert C. Dykes MD1, Catherine S. Amos OD1, Robert A. Head MD1, Dennis D. Juranek DVM1, and Kenneth Walls PhD1

1 Departments of Pediatrics and Microbiology, School of Medicine, University of Alabama in Birmingham, and the Parasitic Diseases Division, Bureau of Epidemiology and Parasitology Division, Center for Disease Control, United States Department of Health, Education and Welfare, Public Health Service, Atlanta

Clinical, serologic, and epidemiologic evidence documents an outbreak of toxoplasmosis involving ten of 30 members of an extended family. The index patient had unusual clinical manifestations including brain abscesses, progressive chorioretinitis, seizures, neurologic deficits, hepatosplenomegaly, pneumonitis, and eosinophilia. Toxoplasmosis was confirmed by demonstrating the organism in brain tissue and cerebrospinal fluids; clinical and serologic evidence also indicated infection with Toxocara (visceral larva migrans). This outbreak of toxoplasmosis was confined largely to preschoolaged children. Of the 11 such children, seven (68%) were seropositive, six of whom had high acute-phase titers (ge1024) to Toxoplasma and a disease consistent with acute toxoplasmosis. All six of the latter group required specific chemotherapy. Geophagia was associated statistically with acute toxoplasmosis among the children; it also increased the risk of infection with Toxocara and enteroparasites. Two school-aged children and two adults had serologic evidence of acute toxoplasmosis, but only one of the group was symptomatic. Epidemiologic evidence indicates that this outbreak was probably caused by ingesting oocysts from cat feces. We suggest that the severe and unusual clinical manifestations of the index patient resulted from simultaneous infection with Toxoplasma and Toxocara.

Submitted on July 9, 1979
Accepted on August 20, 1979




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