OCULAR TOXOPLASMOSIS

Ocular toxoplasmosis is a disease of the retina caused by an intracellular protozoan parasite called Toxoplasma gondii. Infection from this organism is thought to occur either by eating food contaminated by cats, by eating undercooked meats, drinking raw milk or from transmission between a mother and her fetus. The major symptoms of ocular toxoplasmosis are floaters and blurred vision in the affected eye. The diagnosis can be confirmed through antibody blood testing.

The following regimen is recommended for some patients with vision threatening toxoplasmosis:

LOADING DOSE:

Clindamycin 300 mg by mouth

Pyrimethamine (Daraprim) 150 mg by mouth

Sulfadiazine 2 gm by mouth

Folinic acid 2.5 mg by mouth

MAINTENANCE DOSAGE:

Clindamycin 300 mg 4 times a day for 4 weeks

Pyrimethamine (Daraprim) 25 mg 1 time a day for 4 weeks

Sulfadiazine 1 gm 4 times a day for 4 weeks

Folinic acid 2.5 mg 3 times a week for 4 weeks

Prednisone 100 mg 1 time a day for 5 days.

Then taper over 4 weeks.

(Prednisone should be taken with an antacid like Maalox; 2 teaspoons by mouth, 4 times a day.)

After the active disease is suppressed, a reactivation may occur at a later date, sometimes associated with stress or immunodeficiency.

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