[Neurotoxoplasmosis]

Toxoplasmosis represents a clinical problem which focuses attention of several specialists due to the multiorgan pathology it induces and difficulties in evaluating the activity of the morbid process. The infection creates a particularly difficult problem in cases when central nervous system is involved, which frequently leads to unfavorable sequelae. Contemporary data have been presented which pertain to the morphology and life cycle of Toxoplasma gondii, sources of the infection and ways through which the protozoon penetrates the host organism. The pathomechanism of disturbances in the course of toxoplasmosis with involvement of central nervous system is described, as related to the stage of invasion and immune responses of cell-mediated or humoral type. The clinical pathology of congenital and acquired toxoplasmosis is presented, including that developing in patients with immune deficiencies. Diagnostic criteria are given, indispensable in evaluating the activity of toxoplasmosis process, based on contemporary laboratory techniques (antigen detection, detection of antibodies to T. gondii antigen, molecular tests, like PCR, and radiological techniques, like CT and MRI studies. The studies are important not only in evaluation of the primary infection and also for appraisal of reactivation of T. gondii invasion in conditions of acquired immunodeficiency (AIDS), in the course of systemic diseases, during immunosuppressive treatment and in patients who without treatment for toxoplasmosis in the first year of life.