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 TOXOPLASMA

Pembimbing: dr. Charles Hutasoit,Sp. A

  dr.Ajuar Ari, Sp.A

Oleh:

!ebr" Loudr"an

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 To#oplasmosis

• $ntrauterine ine%tion  intra%ellularparasite  Toxoplasma gondii

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$nsiden%e

• &'&( ) li*e births

• +(('+((( %ongenital abnormalit" )

"ear• Serolog" sur*e"  (- SA/ 0('1(-

2urope

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2pidemiolog"

• 01- Central 2uropean

• 0&345- Latin'Ameri%an

•

0+344- 6est Ari%an• +37-south8est Asia, China, and

9orea

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Patoph"siolog"

Oocyst%ats stool ;4'&+

d"s<

sporulation ;5+'51 d"s<

be%omeine%ti*e 3intermediate host%onsumingra8 meat or %ontaminatedpenetrationto gastro intestinal b"

sporozoit%ir%ulates in blood stream asta%h"=oit

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>is? !a%tors

• 2ating ) %onta%t 8ith ra8)under%oo?ed meat

•

Cleaning the %at litter bo#• 2ating un8ashed *egetables)

ruitse#posure to soil

•

 Tra*el outside:S, 2urope, Canada,et%

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Clini%al Maniestation

Obstructive hydrocephalusChorioretinitisDifuse intracranial calsication

!e*er Hepatosplenomegl" L"phadenopath" @omit H"pothrmia

H"perbilirubinemia Opti% atroph" Mi%rophthalmia >ash Pneumonia

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iagnose

Laboratory

Maternalserologi%

Be8born%lini%al suspi%ion serologi%

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Serologi%

Maternal:

• $gDpea? %onsentration &'5monthsremains ;<

• $gM;< &'5 8ee?spersists months or"ears

•

$gM E $gD ;'<

hasnt been e#posed

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Serologi% ;5<

Perinatal:

• iagnosis amnioti% Fuid PC>

•

Cordo%enthesishigh ris? etal injur"• $gM E $gA antibod" %ross pla%enta

serodiagnosis  %ongenital ine%tion 

li*e ne8born

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>adiolog" studies

• Cranial ultrasonogrm or CT s%an o head

diGuse intra%ranial %al%i%ation

• Long'bone lmsmetaph"seal lu%en%" andirregularit" o %al%i%ation line at epiph"seal

plate 8ithout periosteal rea%tion

• Other stud" Ophthalmologi% e#am %hara%teristi%all" sho8n %horioretinitis.

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 Treatment

• Suladia=ine 0( mg)?g, 5#)da"

• P"rimethamine 5 mg)?g)da", or 5 da"s

  then, & mg)?g)da" or 5'I months

  then, & mg)?g)da", #)8ee?

• !olini% a%id &( mg, #)8ee?

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Pre*ention

• Counseled about to#oplasma

• Coo?ing meat to sae temperature

• Peeling or thoroughl" 8ashing ruits and

*ege• Cleaning %oo?ing tools ater %onta%ted ra8

meat

• Bot eeding ra8 meat

• 9eep %at inside

• Se%ondar" pre*ention serologi%s%reening

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Prognosis

• Maternal during &'5 smt stillbirth;0-<

perinataldeath ;4-<

• Congenital to#o mortalit" ;&5-<

  ris? in lie ;sei=ure, deaness,mental retard, *isual

impair, learning disorder<

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 Than? Jou