[Usefulness of serological assays in diagnosis of early phase of toxoplasma gondii infection]. / Przydatnosc odczynów serologicznych w rozpoznawaniu wczesnej fazy zarazenia Toxoplasma gondii.

OBJECTIVE: The aim of the study was to evaluate value of certain serological assays in differential diagnosis between early and late phase of T. gondii infection. METHODS: 92 patients (58 with nodular toxoplasmosis and 34 asymptomatic women with T. gondii infection diagnosed during or after pregnancy) with different time from onset of infection were tested for T. gondii antibodies with IFA, ISAGA IgM, ELISA IgM, ELISA IgA and IgG avidity assays. Sensitivity and specificity of certain assays was evaluated. RESULTS: IFA had sensitivity 76.19% with specificity 31.67%, ISAGA IgM and ELISA IgM had sensitivity 100% with specificity 16.67% and 23.33% respectively. ELISA IgA had sensitivity 76.19% or 85.71% depending on counting borderline results to positive or negative, with specificity 35% and 25% respectively. IgG avidity had sensitivity 100% with specificity 41.67%. CONCLUSIONS: All evaluated assays have only limited value in differentiation between early and late toxoplasmosis. IgA assay is not superior to IgG and IgM assays. IgG avidity is the most specific and sensitive method of such differentiation.

[Some aspects of immune response in toxoplasmosis]. / Niektóre aspekty odpowiedzi immunologicznej w toksoplazmozie.

OBJECTIVE: The study was performed to determine cell-mediated and humoral responses related to the clinical course of disease in adults with different forms of toxoplasmosis. METHODS: The cellular response was estimated by blastogenic transformation of T-lymphocytes induced by OKT3 mitogenic stimulus, as well as by a specific soluble toxoplasmic antigen. The phenotype analysis of T-lymphocytes was performed using monoclonal antibody on FACS flow cytometer. The humoral response was examined by determining the levels of toxoplasma-specific IgA, IgM and IgG antibodies and total serum immunoglobulins. RESULTS: Significant disruption of the cell-mediated response was not observed (T-lymphocyte proliferation test). In the group of patients with lymphadenopathy, an increased proportion of CD8+ lymphocytes was only noted in the first month of the disease, although enlargement of the cervical lymph nodes was observed for up to a year. The individuals in question were found to have IgA antibodies against the p30 antigen of T. gondii, mainly in the period of disease up to 7 months. The proportion of CD4+ lymphocytes was sub-normal in all patients of this group who were studied in the first two months of the disease, and in most of those studied later. Three out of 14 patients with the ocular form of toxoplasmosis only had recent foci of inflammation in the retina, and were also found to have specific IgM. These patients had depressed CD4+ levels, and showed no reaction from CD8+ lymphocytes. CONCLUSIONS: Sub-normal CD4+ population could have been the cause of the weak stimulation of CD8+ cells and an expression of this is the long course of disease. Sub-normal CD4+ cells may be also results the suppressing effect of the parasite.

[Hospital infection of tropical malaria in Poland]. / Zakazenie szpitalne zimnica tropikalna w Polsce.

Two cases are reported of severe tropical malaria in individuals who never had been in the areas of endemic malaria. The infection occurred in hospital by a iatrogenic mechanism.