toxoplasma gondii gram stain

Signs and symptoms of ocular toxoplasmosis can include reduced vision, blurred vision, pain (often with bright light), redness of the eye, and sometimes tearing. Molecular techniques can be also used to detect that parasite's DNA in tissues and body fluids. To deliver a definitive diagnosis, the healthcare provider will often need to exclude other illnesses with similar features. If you do not have electronic ordering capability, use an ARUP Immunohistochemistry Stain Form (form #32978) with an ARUP client number. Once a diagnosis of toxoplasmosis is confirmed, you and your health care provider can discuss whether treatment is necessary. Toxoplasmosis is an infection caused by a single-celled parasite called Toxoplasma gondii. Resources for health professionals. A Toxoplasma-positive reaction, stained by immunofluroescence (IFA). [80] The pathogen can be released either by lysis of the amoebae or by exocytosis, but this is understudied [81]. If you are pregnant and test positive for both IgG and IgM, your healthcare provider will want to establish when the infection took place. [33] Tachyzoites are also known as "tachyzoic merozoites" and bradyzoites as "bradyzoic merozoites". Winiecka-Krusnell, J., Dellacasa-Lindberg, I., Dubey, J., & Barragan, A. [35] Continuous IFN- production is necessary for control of both acute and chronic T. gondii infection. By clicking Accept All Cookies, you agree to the storing of cookies on your device to enhance site navigation, analyze site usage, and assist in our marketing efforts. If the patient is pregnant, and IgG/IgM positive, an IgG avidity test should be performed. During different periods of its life cycle, individual parasites convert into various cellular stages, with each stage characterized by a distinct cellular morphology, biochemistry, and behavior. Amoeba-resisting bacteria found in multilamellar bodies secreted by Dictyostelium discoideum: social amoebae can also package bacteria. Ideally, cats should be kept indoors and fed only food that has low to no risk of carrying oocysts, such as commercial cat food or well-cooked table food. A test that measures immunoglobulin G (IgG) is used to determine if a person has been infected. Remington JS, McLeod R, Wilson CB, Desmonts G. Toxoplasmosis. Figure C: Central, healed retinochoroiditis. Defenders of Wildlife. [7] The primary mechanisms of T. gondiiinduced behavioral changes in rodents occur through epigenetic remodeling in neurons that govern the relevant behaviors (e.g. T. gondii is considerably more severe in pigeons, particularly crown pigeons, ornamental pigeons, and pigeons originating from Australia and New Zealand. Teach children the importance of washing hands to prevent infection. Centers for Disease Control and Prevention. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. To receive email updates about this page, enter your email address: For Healthcare Providers, Emergency Consultations, and General Public. Jeremy M. Norman (ed. [102] A Turkish study confirmed this holds true among drivers. [27]:359, Initially, a T. gondii infection stimulates production of IL-2 and IFN- by the innate immune system. Intermediate hosts in nature (including birds and rodents) become infected after ingesting soil, water or plant material contaminated with oocysts . In Cuba, despite the highly active antiretroviral therapy, TE is still the most important cause of cerebral mass lesions in patients infected with the human immunodeficiency virus (HIV). Indeterminate: obtain a new specimen for testing or retest this specimen for IgG in a different essay. [5][6], In rodents, T. gondii alters behavior in ways that increase the rodents' chances of being preyed upon by felids. Most common parasite infection in the U.S. Cats are the only known definitive host (, Humans infected through contaminated soil, pet litter boxes and ingesting undercooked meat, Unilateral posterior cervical lymphadenopathy is classic presentation, Infection during pregnancy can be detrimental to the fetus: congenital toxoplasmosis, Perifollicular / interfollicular epithelioid histiocytes, Affects children and young adults most commonly, 1.9% IgM and 32.9% IgG seroprevalence globally (. Interaction of Mycobacterium avium with environmental amoebae enhances virulence. Centers for Disease Control and Prevention. Further studies of toxoplasmosis in birds. Parasites can also be isolated from blood or other body fluids (for example, CSF) but this process can be difficult and requires considerable time. Toxoplasmosis (tok-so-plaz-MOE-sis) is an infection with a parasite called Toxoplasma gondii. [31][4]:107, Intermediate hosts found include pigs, chickens, goats, sheep[27]:2 and Macropus rufus by Mor et al. Immunohistochemical staining performed on block A1 shows that the CD20+ B cells are confined to the germinal centers, while the CD3+ T cells are interfollicular. Animals bred for human consumption and wild game may also become infected with tissue cysts after ingestion of sporulated oocysts in the environment. Depending on the results, your health care provider . Your veterinarian can answer any other questions you may have regarding your cat and risk for toxoplasmosis. You can review and change the way we collect information below. You have been infected within the past 12 months. In warm-blooded animals, such as brown rats, sheep, and dogs, T. gondii has also been shown to be sexually transmitted. The specific genetic sequence of a given MHC molecule differs dramatically between individuals, which is why these molecules are involved in transplant rejection. Immunohistochemical stain for toxoplasma is positive. Thank you for taking the time to confirm your preferences. This website is intended for pathologists and laboratory personnel but not for patients. If you have a weakened immune system, ask your doctor about having your blood tested forToxoplasma. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. Cysts are usually spherical in the brain but more elongated in cardiac and skeletal muscles. Pathology Outlines - Toxoplasmosis However, 10% to 20% of patients with acute infection may develop cervical lymphadenopathy and/or a flu-like illness. Infection is common in many warm-blooded animals, including humans. In the second situation, a second specimen should be drawn and both specimens submitted together to a reference lab which employs a different IgM testing system for confirmation. There are a number of non-invasive photographic techniques used to determine the extent of the eye damage. attachment to biofilms). Centers for Disease Control and Prevention. Laboratory Diagnosis of Congenital Toxoplasmosis. On the whole, there was little evidence that T. gondii was related to increased risk of psychiatric disorder, poor impulse control, personality aberrations, or neurocognitive impairment. The overall seroprevalence in the United States among adolescents and adults, as determined with specimens collected by the third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994, was found to be 22.5%, with a seroprevalence among women of childbearing age (15 to 44 years) of 15%. No approved human vaccine exists against Toxoplasma gondii. Toxoplasmosis - Symptoms and causes - Mayo Clinic [27]:580 However, the perpetual presence of cysts appears to be due to a periodic process of cyst rupturing and re-encysting, rather than a perpetual lifespan of individual cysts or bradyzoites. In: Remington JS, Klein JO, editors. [73] An examination on 105 beachcast otters revealed that 38.1% had parasitic infections, and 28% of said infections had resulted in protozoal meningoencephalitis deaths. If you have a weakened immune system, please see guidelines for Immunocompromised Persons. The life-cycle of Toxoplasma gondii reviewed using animations For pregnant women or persons who have weakened immune systems, medications are available to treat toxoplasmosis. Toxoplasmosis - Diagnosis and treatment - Mayo Clinic Newborn infants suspected of congenital toxoplasmosis should be tested by both an IgM- and an IgA-capture EIA. You have been infected with T. gondii for less than six months. Unsporulated oocysts are shed in the cat's feces . Dennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. There is no evidence of lymphoma. [100][101] Thus, a computerized simple reaction test was given to both infected and non-infected adults. For additional technical details, please contact ARUP Client Services. The ability of the microorganism to survive in vitro is dependent on the microorganism itself, but there are a few overarching mechanisms present. These cookies may also be used for advertising purposes by these third parties. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Sporozoites are the stage of the parasite residing within oocysts. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. If the patient has clinical illness compatible with toxoplasmosis but the IgG titer is low, a follow-up titer two to three weeks later should show an increase in antibody titer if the illness is due to acute toxoplasmosis, assuming the host is not severely immunocompromised. 2017;57:1-12. doi:10.1159/000449169, Villard. A; Cimon, B; L'Olivier, C.Serological diagnosis ofToxoplasma gondiiinfection: Recommendations from the French National Reference Center for Toxoplasmosis. Conrad, P., Miller, M., Kreuder, C., James, E., Mazer, J., Dabritz, H., Gulland, F. G. (2005). Some people who have toxoplasmosis may feel as if they have the flu with swollen lymph glands or muscle aches and pains that may last for a month or more. This information has been adapted from the websites of United States Centers for Disease Control and Prevention[64] and the Mayo Clinic.[65]. You will be subject to the destination website's privacy policy when you follow the link. If results for the second specimen remain the same, the IgM reaction is probably a false-positive. They may be found in various sites throughout the body of the host, but are most common in the brain and skeletal and cardiac muscles. The following precautions are recommended to prevent or greatly reduce the chances of becoming infected with T. gondii. Risk Factors for, I.C.L., A., A.F., S.-F., Munoz-Leal, S., Soares, H., M.B., H., Moreno, L., Gennari, S. (2019). ), Morton's Medical Bibliography. [28], Ingestion of oocysts by humans or other warm-blooded animals is one of the common routes of infection. Toxoplasma encephalitis, characterized by inflammation of the brain, is a serious complication most often seen in people with advanced HIV. *Freezing does not reliably kill other parasites that may be found in meat (like certain species of. What Does a Positive Herpes IgM Test Result Mean? Detection of parasite genetic material by PCR, especially in detecting congenital infections in utero. [27]:343 However, specific tissue tropisms can vary between intermediate host species; in pigs, the majority of tissue cysts are found in muscle tissue, whereas in mice, the majority of cysts are found in the brain. Toxoplasma Gondii - Medical Microbiology - NCBI Bookshelf Intravenous contrast dyes can be used to enhance the images. The following have been identified as being risk factors for T. gondii infection in humans and warm-blooded animals: A common argument in the debate about whether cat ownership is ethical involves the question of Toxoplasma gondii transmission to humans. If no one else can perform the task, wear disposable gloves and wash your hands with soap and water afterwards. Treatment information for toxoplasmosis can be found at: https://www.cdc.gov/parasites/toxoplasmosis/health_professionals/index.html#tx. Toxoplasma gondii is a protozoan which can invade many cell types ( Ioachim: Ioachim's Lymph Node Pathology, 4th Edition, 2008 ) Lymph nodes are commonly affected: unilateral posterior cervical node is characteristic Other lymph nodes can often be involved Generalized lymphadenopathy or hepatosplenomegaly unusually occurs [27]:3940. Accidentally ingesting contaminated soil (e.g., not washing hands after gardening or eating unwashed fruits or vegetables from a garden). Toxoplasma gondii: Morphology, Lab diagnosis-NotesMed Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Typical onset is quick and usually results in death. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. . (See below). While the parasite is found throughout the world, more than 40 million people in the United States may be infected with the Toxoplasma parasite. Monocytoid B cells also express CD20. Because of the mink's ability to transverse land more frequently, and often seen as an invasive species itself, minks are a bigger threat in transporting T. gondii to other mammalian species, rather than otters who have a more restrictive breadth. What is the best technique for staining Toxoplasma gondii tachyzoites Other unsafe practices such as drinking unpasteurized milk or untreated water can increase odds of infection. Because increased rainfall directly increases the flow rate in rivers, the amount of flow into coastal areas is increased as well. [50][60], Specific vectors for transmission may also differ based on geographic location. Epidemiology & risk factors, ParasitesToxoplasmosis (Toxoplasma infection). Mother-to-child (congenital) transmission. It suggested that infection with this parasite emboldened infected wolves into behavior that determined leadership roles and influenced risk-taking behavior, perhaps even motivating establishment of new independent packs that they would establish and lead in behavior patterns differing from that of the packs into which they were born. [27]:2339 Tachyzoites multiply inside this vacuole until the host cell dies and ruptures, releasing and spreading the tachyzoites via the bloodstream to all organs and tissues of the body, including the brain. Toxoplasmosis can be diagnosed with antibody tests that detect two specific T. gondii immunoglobulins: The IgG antibody test is the first test used to determine whether you have been infected with T. gondii. Serologic testing is the routine method of diagnosis. [29] Felids are therefore the definitive hosts of T. gondii; all other hosts (such as human or other mammals) are intermediate hosts. Many infants with subclinical infection at birth will subsequently develop signs or symptoms of congenital toxoplasmosis. If results for the second specimen remain the same, the patient is probably not infected with. 2015 find TgCDPK3 is required to begin the action of motility because it phosphorylates T. gondii's myosin A (TgMYOA). [11][12], In humans, particularly infants and those with weakened immunity, T. gondii infection is generally asymptomatic but may lead to a serious case of toxoplasmosis. Almost all species of birds that have been tested for Toxoplasma gondii have shown to be positive. Parks S, Avramopoulos D, Mulle J, McGrath J, Wang R, Goes F S, Conneely K, Ruczinski I, Yolken R, Pulver A E. HLA typing using genome wide data reveals susceptibility types for infections in a psychiatric disease enriched sample. J Clin Microbiol. [42][43] Gaji et al. Unsporulated oocysts are shed in the cats feces . Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Read our, Treatment and Prevention of Toxoplasmosis. There usually is little need to worry about passing the infection to your baby. The treatment regimen varies depending on the situation, but usually involves a combination of pyrimethamine and sulfadiazine or clindamycin. Microscopic examination of the biopsied tissue will usually reveal T. gondii in its active, replicating state. Toxoplasmosis can be difficult to distinguish from other diseases, particularly in people with compromised immune systems who are prone to multiple infections. The first conclusive identification of T. gondii in humans was in an infant girl delivered full term by Caesarean section on May 23, 1938, at Babies' Hospital in New York City. This creates a dangerous environment for organisms that have not evolved in cohabitation with felines and their contributing parasites. [96], There are many instances where behavioural changes were reported in rodents with T. gondii. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. [115][116] In addition to additional dopamine production, T. gondii infection also produces long-lasting epigenetic changes in animals that increase the expression of vasopressin, a probable cause of alterations that persist after the clearance of the infection.[117]. Wildlife disease ecology in changing landscapes: Mesopredator release and toxoplasmosis. Distinctive features on electron microscopy: Toxoplasma genomes are detected by conventional and nested PCR. [29], In 1984 Elmer R. Pfefferkorn published his discovery that treatment of human fibroblasts with human recombinant interferon gamma blocks the growth of T. The bradyzoites and tachyzoites of Toxoplasma gondii are quite characteristic. [35] Thus, T-cells play a central role in immunity against Toxoplasma infection. Laboratory tests can detect two types of antibodies. Eating undercooked meat of animals harboring tissue cysts, Consuming food or water contaminated with cat feces or by contaminated environmental samples (such as fecal-contaminated soil or changing the litter box of a pet cat), Blood transfusion or organ transplantation. CDC twenty four seven. Retrieved from Defenders of Wildlife: Ahlers, A. TOXGP - Overview: Toxoplasma gondii Antibody, IgG, Serum [88], The genomes of more than 60 strains of T. gondii have been sequenced. Computed tomography (CT) scans remain one of the primary modes of diagnosis. Most infants who are infected while still in the womb have no symptoms at birth, but they may develop symptoms later in life. [35], The IFN--mediated activation of IDO and TDO is an evolutionary mechanism that serves to starve the parasite, but it can result in depletion of tryptophan in the brain of the host. [37], Consumption of tissue cysts in meat is one of the primary means of T. gondii infection, both for humans and for meat-eating, warm-blooded animals. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. Urbanization and global warming are extremely influential in the transmission of T. The only known definitive hosts forToxoplasma gondiiare members of family Felidae (domestic cats and their relatives). Do not eat raw or undercooked oysters, mussels, or clams (these may be contaminated with, Wear gloves when gardening and during any contact with soil or sand because it might be contaminated with cat feces that contain, Ensure that the cat litter box is changed daily. [67] Research on human vaccines is ongoing. A small percentage of infected newborns have serious eye or brain damage at birth. IDO and TDO degrade tryptophan to N-formylkynurenine. In that age group, IgG antibodies usually are the result of passive transfer from the mother. [94] The same year Nicolle and Mancaeux discovered T. gondii, Alfonso Splendore identified the same organism in a rabbit in Brazil. Felines are the only definitive host because they lack expression of the enzyme delta-6-desaturase (D6D) in their intestine. Correlation has also been observed between seroprevalence of T. gondii in humans and increased risk of traffic accidents. Following the initial period of infection characterized by tachyzoite proliferation throughout the body, pressure from the host's immune system causes T. gondii tachyzoites to convert into bradyzoites, the semidormant, slowly dividing cellular stage of the parasite. There is no effective vaccine for T. gondii, and research on a live vaccine is ongoing. T. gondii oocysts have been found to resist an acidic pH and, thus, are protected by the acidification found in endocytic vacuoles and lysosomes. Normally, amoebas function as a natural filter, phagocytizing nutrients and bacteria found within the water. Once infected with Toxoplasma is my cat always able to spread the infection to me? The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. [27]:2[30] Although cats can also be infected by ingesting oocysts, they are much less sensitive to oocyst infection than are intermediate hosts. Comment: The classic triad present in this case (follicular hyperplasia, intrafollicular clusters of epithelioid cells and aggregates of monocytes) is reported to have a 91% specificity for toxoplasma lymphadenitis. [69], In humans, active toxoplasmosis can be treated with a combination of drugs such as pyrimethamine and sulfadiazine, plus folinic acid. The study determined that at times, an infected wolf would become the only breeding male in a pack,[118] leading to a significant effect on another species by "T. gondii. Research has shown that UV-C disinfection of water containing oocysts results in inactivation and possible sterilization. [85] Temperature and humidity are huge factors in the sporulation stage: low humidity is always fatal to the oocysts, and they are also vulnerable to extreme temperatures. Toxoplasma gondii is an intestinal coccidium that parasitizes members of the cat family as definitive hosts and has a wide range of intermediate hosts. [109], Published research has also indicated that T. gondii infection could potentially promote changes in a persons political beliefs and values. [29], In 2006, researchers reviewed evidence that T. gondii has an unusual population structure dominated by three clonal lineages called Types I, II and III that occur in North America and Europe, despite the occurrence of a sexual phase in its life cycle. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Ocular Toxoplasma infection, an important cause of retinochoroiditis in the United States, can be the result of congenital infection, or infection after birth. gondii. [99] Mice infected with T. gondii have a worse motor performance than non-infected mice. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Infected males had higher levels of testosterone while infected females had significantly lower levels, compared to their non-infected equivalents. [13][4] T. gondii can initially cause mild, flu-like symptoms in the first few weeks following exposure, but otherwise, healthy human adults are asymptomatic. Immunodeficient patients often have central nervous system (CNS) disease but may have retinochoroiditis, pneumonitis, or other systemic disease. Saving Lives, Protecting People, Parasites - Toxoplasmosis (Toxoplasma infection), Division of Parasitic Diseases and Malaria, U.S. Department of Health & Human Services. DPDx - Laboratory Identification of Parasites of Public Health Concern: Toxoplasmosis. They help us to know which pages are the most and least popular and see how visitors move around the site. No, cats only spreadToxoplasmain their feces for 1-3 weeks following infection with the parasite. Wash your utensils, cutting boards, and countertops with hot, soapy water after preparing each food item. [27]:3 Humans consume tissue cysts when eating raw or undercooked meat (particularly pork and lamb). An antibody test is one that measures specific immunoglobulins in your blood. Oocysts in cat feces take at least a day to sporulate (to become infectious after they are shed), so disposing of cat litter daily greatly reduces the chance of infectious oocysts developing. [27]:580 At any given time in a chronically infected host, a very small percentage of cysts are rupturing,[27]:45 although the exact cause of this tissue cyst rupture is, as of 2010, not yet known. "The seawater in California is thought to be contaminated by T. gondii oocysts that originate from cat feces, survive or bypass sewage treatment, and travel to the coast through river systems. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Ophthalmic Res. On the other hand, women were more warm-hearted, outgoing, conscientious, and moralistic. Toxoplasma gondii by IHC: 2004159: Toxoplasma gondii Reference Number: 94736-6 An Annotated Check-list of Texts Illustrating the History of Medicine (Garrison and Morton). In most cases infection is asymptomatic, but devastating disease can occur. Evaluation of antibodies against. The Weigert Gram stain highlights gram positive organisms blue but does not stain gram negative organisms. It is also a serious condition in immunodeficient patients. [79] For this, the healthcare provider would need to perform an IgG avidity test. The first case of. Contributed by Tayler A. van den Akker, M.D. AToxoplasmainfection occurs by one of the following: People who are most likely to develop severe toxoplasmosis include: If you are planning to become pregnant, your health care provider may test you forToxoplasma gondii. [114] T. gondii has two genes that code for a bifunctional phenylalanine and tyrosine hydroxylase, two important and rate-limiting steps of dopamine biosynthesis. If there is any doubt as to the interpretation, specialist consultation would be needed. Persons should be initially tested for the presence of Toxoplasma-specific IgG antibodies to determine their immune status. The persistence of antibodies not only provides us a long-lasting "footprint" of the infection, it can sometimes even tell us when the infection occurred. It readily invades and multiplies in a wide variety of fibroblast and monocyte cell lines. International Journal for Parasitology: Parasites and Wildlife, 11018. [29], In 1970, oocysts were found in (cat) feces. (P<0.005) [106], As mentioned before, these results of increased proportions of people seropositive for the parasite in cases of these neurological disorders do not necessarily indicate a causal relationship between the infection and disorder. We welcome suggestions or questions about using the website. [105] Infection was also shown to be associated with suicide in women over the age of 60. Epithelioid histiocytes, monocytoid B cells, Toxoplasma tissue cyst within an intact neurone, Classic histomorphology of toxoplasma lymphadenitis, Great teaching case of cerebral toxoplasmosis, Vote for your favorite image from the PathologyOutlines.com Directory. If the test is negative, take necessary precautions to avoid infection (See below). When an uninfected host consumes a tissue cyst, bradyzoites released from the cyst infect intestinal epithelial cells before converting to the proliferative tachyzoite stage. Neuroinflammation-Associated Aspecific Manipulation of Mouse Predator Fear by. Severe toxoplasmosis, causing damage to the brain, eyes, or other organs, can develop from an acute. [64] As T. gondii is commonly transmitted through ingesting microscopic cysts in the tissues of infected animals, meat that is not prepared to destroy these presents a risk of infection. To this end, the IgG and IgM results need to be interpreted together in order to deliver a confident diagnosis. The interpretation is largely based on the level (titer) of antibodies in the test, with higher values generally corresponding to a greater level of certainty. Keep cats indoors. The possibility of T. gondii transmission via consumption of undercooked meat was first proposed by D. Weinman and A.H Chandler in 1954. They concluded that further studies should be performed. The lifecycle of T. gondii may be broadly summarized into two components: a sexual component that occurs only within cats (felids, wild or domestic), and an asexual component that can occur within virtually all warm-blooded animals, including humans, cats, and birds. Retest IgM. There have been no studies on the ability of T. gondii oocysts lifecycle within freshwater environments, although infections are still present. [27]:359 Following the initial period of proliferation throughout the host body, tachyzoites then convert back to bradyzoites, which reproduce inside host cells to form tissue cysts in the new host. These stages include the tachyzoites, merozoites, bradyzoites (found in tissue cysts), and sporozoites (found in oocysts). When a feline is infected with T. gondii (e.g. Description and significance. Receiving an infected organ transplant or infected blood via transfusion, though this is rare. A specific immunohistochemical stain is available. Ophthalmologists sometimes prescribe medicine to treat active disease. Well formed granulomas with multinucleated giant cells, Early stages of HIV lymphadenitis may mimic toxoplasmosis, Pattern A: aggregates of monocytoid cells and florid follicular hyperplasia, May lack clusters of epithelioid cells or may be present, Necrosis and fibrosis present with Leishmania infection, Histiocytes contain Leishman-Donovan bodies within the cytoplasm (, Electron microscopy demonstrates presence of rod shaped kinetoplast and target shaped basal body, Paracortical distribution of of histiocyte collections, pigment and lipids, Florid follicular hyperplasia, perifollicular epithelioid histiocytes and patches of monocytoid B cells, Reactive follicular hyperplasia, T cells and a lack of histiocytes, Cysts containing tachyzoites localize in tissues (skeletal muscle, brain and eyes), Oocysts are shed, unsporulated, in the feces of cats and sporulate in the environment to become infective, Rodents, cats and birds are definitive hosts, while humans are intermediate hosts.

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