Toxoplasma gondii (Toxoplasmosis)

Summary of Toxoplasma gondii (Toxoplasmosis)
Toxoplasma gondii is an obligate intracellular, parasitic protozoan that causes the disease toxoplasmosis. Found worldwide, T. gondii is capable of infecting virtually all warm-blooded animals, but felids such as domestic cats are the only known definitive hosts in which the parasite can undergo sexual reproduction. Cleaning cat litter boxes is a potential route of infection. Transmission is by ingesting cysts in undercooked meat. It is part of ToRCHeS infections and if transmission occurs in a pregnant woman, the fetus can acquire congenital toxoplasmosis consisting of the triad of chorioretinitis, hydrocephalus, and intracranial calcifications. 

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Toxoplasma gondii (Toxoplasmosis)

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Toxoplasma gondii (Toxoplasmosis)

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Toxoplasma gondii brain calcifications (are/are not) localized periventricularly, in contrast to cytomegalovirus brain infection.

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A 50-year-old woman comes to the emergency department because of a seizure. She denies any history of seizures or trauma. Social history reveals a smoking history of 5 packs a day for the past six years, and intravenous drug abuse for fifteen years. She does not see a physician regularly and denies any known past medical history. Physical examination reveals an afebrile malnourished female and a weakened right upper extremity. An MRI of the brain is obtained and reveals multiple ring-enhancing lesions. Which is the most appropriate treatment in this patient?   

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