RESUMO
Toxoplasmosis is an infection caused by Toxoplasma gondii, an intracellular obligate parasite. Its transmission has usually been attributed to ingestion of undercooked or raw meat. The frequency of T. gondii in pork, the most common meat for human consumption in Jalisco, Mexico, is unknown; in Guadalajara city high prevalence of human toxoplasmosis has been documented. Forty-eight samples of pork meat from butcher shops in Ocotlán city were analyzed. Through bioassay, 50 g of tissue was homogenized in an acidic pepsin solution and inoculated subcutaneously to previously immunosuppressed mice. Blood samples from the mice tail vein were obtained before inoculation and 7, 14, 28, and 45 days postinoculation to analyze anti-Toxoplasma immunoglobulin (Ig) M and IgG antibody kinetics by indirect enzyme-linked immunosorbent assay. For histopathology, small fragments of the brain, lungs, heart, and skeletal muscle were extracted on day 45 and were stained with hematoxylin and eosin. Also, DNA was extracted from the pork meat for PCR amplification of the B1 gene. Even though all pork samples were negative by histopathology and PCR, IgG and IgM antibodies against T. gondii were detected in 1 of the 48 inoculated mice, reflecting a frequency of 2.1% positive pork meat, which is lower than expected but similar to that found in other regions.
Assuntos
Contaminação de Alimentos/análise , Parasitologia de Alimentos , Carne/parasitologia , Toxoplasma/isolamento & purificação , Animais , Anticorpos Antiprotozoários/sangue , Bioensaio , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , México/epidemiologia , Camundongos , Prevalência , Suínos , Toxoplasma/imunologia , Toxoplasmose/prevenção & controle , Toxoplasmose/transmissão , Toxoplasmose Animal/imunologia , Toxoplasmose Animal/parasitologia , Toxoplasmose Animal/patologiaRESUMO
A 7-year-old Mexican boy with end-stage cirrhosis underwent liver transplantation and was maintained with cyclosporine and prednisolone. No specific data about Toxoplasma gondii or cytomegalovirus (CMV) infections in the cadaver donor were available. The recipient was seronegative for Toxoplasma, but CMV-IgG positive before transplantation. Ganciclovir was administered for prophylaxis during 3 months, but 5 months later he presented with icterus and increased transaminases. Acute transplant rejection was ruled out by biopsy. A seroconversion for T. gondii IgM and IgG and a small increase in CMV-IgM antibodies were observed, although the CMV-polymerase chain reaction (PCR) was negative. Ganciclovir was re-started, and the patient improved, but 6 months later he relapsed, and chorioretinitis lesions compatible both with T. gondii and CMV infections appeared. Pyrimethamine, sulfadiazine, folinic acid, and ganciclovir were administered. The boy showed favorable clinical improvement and remained stable for 12 months. Then, new retinal CMV lesions appeared in both eyes and the PCR for CMV became positive; therefore, the patient received a new regimen of ganciclovir, and clinically improved. From these data we concluded that the child presented a reactivation of CMV and a primary infection with T. gondii after transplantation.