Service de Parasitologie, Faculté de Médecine et Centre Hospitalier Universitaire de Rennes, Rennes, France.
Clin Microbiol Rev. 2012 Apr;25(2):264-96. doi: 10.1128/CMR.05013-11.
The apicomplexan parasite Toxoplasma gondii was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years. This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection. Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection. In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes. In particular, we provide critical information on diagnostic methods according to the patient's background and discuss the implementation of screening tools for congenital toxoplasmosis according to health policies.
刚过 100 年前，人们发现了顶复线虫目寄生虫弓形虫，但在过去 40 年中，人们对其生物学生命周期和医学重要性的了解不断增加。这种专性细胞内寄生虫很早就被确定为导致先天性感染的病原体，但直到器官移植和 HIV 感染时代，人们才认识到其临床表现和免疫功能低下患者感染再激活的重要性。宿主细胞-寄生虫相互作用和寄生虫毒力的最新知识为理解感染的病理生理学带来了新的认识。在这篇综述中，我们重点关注流行病学和诊断方面，并结合寄生虫基因型的现有知识进行了讨论。特别是，我们根据患者背景提供了有关诊断方法的重要信息，并根据卫生政策讨论了先天性弓形虫病筛查工具的实施。
