Cytology as a tool in diagnosis of...
Transcript of Cytology as a tool in diagnosis of...
![Page 1: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/1.jpg)
Cytology as a tool in diagnosis of Toxoplasmosis
Kausalya K Sahu, Pooja K Suresh, Flora D Lobo, Chaitra GV, Sridevi HB
Department of Pathology, Kasturba Medical College, Mangalore,
Manipal Academy of Higher Education (MAHE)
![Page 2: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/2.jpg)
INTRODUCTION
• Toxoplasmosis: one of the commonest parasitic infections worldwide
• Caused by protozoa Toxoplasma gondii.1
• Usually diagnosed by serology.
• Cytological techniques are rarely used for identification of the organisms.2,3
![Page 3: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/3.jpg)
• We report 3 cases, in which various cytological methods helped in
• revealing the diagnosis as well as identifying the organism
directly.
![Page 4: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/4.jpg)
CASE - 1
• A 46-year-old woman presented with fever, cough and right
sided cervical lymphadenopathy for 2months duration.
• Physical examination revealed an enlarged lymph node in the
right posterior triangle, measuring 1.5cm in diameter.
• FNAC was performed
![Page 5: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/5.jpg)
• FNAC showed reactive lymphoid hyperplasia with an ill formed microgranuloma
• A large spherical cyst, containing numerous bradyzoites
• Suggestive of toxoplasma lymphadenitis.
• Serology showed elevated levels of IgM.
![Page 6: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/6.jpg)
REACTIVE LYMPHOID HYPERPLASIA
![Page 7: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/7.jpg)
MICROGRANULOMAS
![Page 8: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/8.jpg)
CYST WITH BRADYZOITES – tissue cyst
![Page 9: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/9.jpg)
CASE -2
• A 6-year-old girl presented with fever since 1month, not
responding to antibiotics.
• Lately, she was irritable and had features of meningitis.
• The tap yielded 0.3ml of hazy CSF with the cell count of
8cells/cumm & predominance of neutrophils.
![Page 10: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/10.jpg)
• The CSF protein 36.9mg/dl & glucose was & 67mg/dl.
• CSF showed numerous conical shaped bradyzoites scattered
throughout the slides.
• India ink was negative.
• Her HIV & HBsAg status was negative.
![Page 11: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/11.jpg)
CONICAL SHAPED BRADYZOITES
![Page 12: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/12.jpg)
CONICAL SHAPED BRADYZOITES
![Page 13: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/13.jpg)
CONICAL SHAPED BRADYZOITES
![Page 14: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/14.jpg)
CASE - 3
• A 59-year-old man, c/o RVD non adherent to treatment,
came with the complaints of vomiting, loose stools and
abdominal pain.
• He also had anemia, leucopenia with elevated ESR.
• CT abdomen → dilation of common bile duct and
intrahepatic biliary radicals.
![Page 15: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/15.jpg)
CT abdomenDilation of common bile duct and intrahepatic biliary radicals.
![Page 16: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/16.jpg)
CT abdomen
Dilation of common bile duct and intrahepatic biliary radicals
![Page 17: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/17.jpg)
• He was positive for HBsAg. His CD4 count is 157/cumm &
viral load was 142277copies/ml.
• ERCP was done.
• Biliary brushing cytology revealed numerous crescent shaped
tachyzoites with occasional tissue cyst suggestive of
toxoplasmosis.
![Page 18: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/18.jpg)
Crescent shaped tachyzoites with bile duct cells
![Page 19: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/19.jpg)
Crescent shaped tachyzoites
![Page 20: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/20.jpg)
CONCLUSION
• Toxoplasmosis is a zoonotic infection in humans.
• Exists in the environment in three forms: tachyzoite,
bradyzoite (tissue cyst), oocyst. 4
• Majority of toxoplasma cases seen in immunocompetent
hosts are subclinical/asymptomatic,
![Page 21: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/21.jpg)
• In immunocompromised hosts and in congenitally infected new borns→ severe symptomatology like
- encephalitis,
- chorioretinitis,
- pneumonia,
- myocarditis etc.5
![Page 22: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/22.jpg)
• Rare presentation of toxoplasmosis like disseminated
toxoplasmosis, toxoplasma pneumonitis, isolated
lymphadenopathy, PUO etc. are reported
• Toxoplasma tachyzoites/bradyzoites have been isolated from
CSF, amniotic fluid, BAL fluid etc.6
![Page 23: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/23.jpg)
• This report highlights the utility of cytological methods in
identification of the organism in 3 rare cases.
• 1. FNAC is a valuable tool for the diagnosis of toxoplasma
lymphadenitis.
• 2. CSF analysis is useful in identification of
- tachyzoites/bradyzoites
- diagnosis of toxoplasma encephalitis.
![Page 24: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/24.jpg)
• 3. Biliary brushings- usefulness in the diagnosis of toxoplasmosis
• Parasites are one of the important causes of biliary strictures,
• To the best of our knowledge this is the first case of finding the organism in biliary brushings.
![Page 25: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/25.jpg)
Source - internet
![Page 26: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/26.jpg)
SYMPTOMS – IN GENERAL
• Body aches
• Swollen lymph nodes
• Headaches
• Fever
• Fatigue
• Symptoms often last for a month or longer.
Source - internet
![Page 27: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/27.jpg)
IMMUNE INCOMPETENT
• Immune incompetent people : HIV or AIDS, individuals
undergoing chemotherapy, and the recipients of organ
transplants show
• re-activation of a previous infection.
![Page 28: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/28.jpg)
Cont’d
• They develop more severe symptoms such as:
- Hadache
- Confusion
- Poor coordination
- Seizures
- Lung infections
![Page 29: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/29.jpg)
OCULAR TOXOPLASMOSIS
• Ocular toxoplasmosis can cause the following symptoms in the eye:
• Decrease in vision
• Blurry vision
• Redness
• Pain, especially when exposed to bright light
• Tearing
Source - internet
![Page 30: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/30.jpg)
IN PREGNANCY, NEONATE AND CHILDREN
• Pregnant woman gets infection with T. gondii, passes
the infection to her newborn infant.
• Infection early in a pregnancy, can result in the loss of the
fetus,
• Infants born with the parasite typically have following symptoms:
- Seizures
-Spleen enlargement
![Page 31: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/31.jpg)
IN NEONATE AND CHILDREN
- Liver enlargement
- Jaundice
- Severe eye infections
• Most often, babies are asymptomtic at birth. Later may
develop symptoms of toxoplasmosis like hearing loss, mental
development issues, or eye infections etc.
![Page 32: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/32.jpg)
DIAGNOSIS
• Morphology and serology (IgM antibody)
• PCR and immunostains are usually negative in lymph nodes
• High IgG avidity only in patients who developed
lymphadenopathy at least 4 months earlier
![Page 33: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/33.jpg)
MORPHOLOGY
• Epithelioid microgranulomas (small clusters of epithelioid
histiocytes with abundant, pale staining and homogenous
cytoplasm and eccentric, oval nuclei but without necrosis,
giant cells or neutrophils) are characteristic
• Background with reactive lymphoid hyperplasia
• Tachyzoites within lymphocytes
• Pap stain may demonstrate parasite on FNA
(Acta Cytol 2005;49:139), (Acta Med Croatica 2005;59:153
![Page 34: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/34.jpg)
• 3 forms of parasites:--
- Tachyzoites→most actively dividing form
- Bradyzoites→ slowly dividing form
when in cluster in cyst in tissues –tissue cyst
- Oocyst→ contains Sporozoites
Clin Microbiol Rev. 1998 Apr; 11(2): 267–299
![Page 35: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/35.jpg)
VACCINATION
• There is no vaccine against toxoplasmosis yet -----• Preventive measures should be taken but are not universally
applied till now. • Thus, there is a need for establishing educational programs
to increase the awareness of the population regarding risk factors, symptoms and transmission of toxoplasmosis also its preventive measures.
(Darweesh N.H., Hussein R.A., Salman S.T. and ShakerM.J..“Immunological and Molecular study of Toxoplasma gondiifrom aborted women in Diyala / Iraq”. Sci. J. Med. Res. 2018, 2 (6): 75-82.)
![Page 36: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/36.jpg)
SANITATION AND FOOD SAFETY TIPS
Precaution measures to minimize Toxoplasma infection in order of importance:
• Do not eat raw or under cooked meat.
• Do not eat unwashed fruits and vegetables.
• Do not drink unpasteurized milk.
• Do not drink environmental water that has not been boiled/filtered.
Source - internet
![Page 37: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/37.jpg)
• Do not feed unpasteurized milk or raw meat to cats.
• Wash hands and food preparation surfaces with warm soapy
water after handling raw meat.
• Wash hands before eating.
• Wear gloves while gardening and wash hands afterwards.
Source - internet
![Page 38: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/38.jpg)
• Keep sandboxes covered and don’t allow cats to use them litter box.
• Do not allow cats to hunt or roam unsupervised.
• Remove feces from the litter box daily and wash it frequently with boiling water.
• Food should be cooked to safe temperatures.
• Fruits and vegetables should be peeled or thoroughly washed before eating.
![Page 39: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/39.jpg)
• Cutting boards, counters, utensils, and hands should be
washed with hot soapy water after contact with raw
meat, poultry, seafood, or unwashed fruits or vegetables.
• Trappers should take special caution to minimize their
ex-posure to faeces when trapping and skinning lynx as lynx
serve s the only wildlife source of Toxoplasma oocysts.
(Rashno M M, Fallahi S, Arab-Mazar Z, Dana H. Seromolecular assess of toxoplasma gondii infection in pregnant women and neonatal umbilical cord blood. EXCLI Journal 2019;18:1-7 )
![Page 40: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/40.jpg)
• Pregnant women should consult obstetricians for
specific serologic testing
• Pregnant women and immune-deficient persons----
should refrain from eating raw meat,
should wear gloves during gardening and any contact
with soil or sand where cat faeces may be present.
![Page 41: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/41.jpg)
• They should avoid scooping or changing cat litter if possible.
• If not then change the litter, using gloves, then wash hands thoroughly.
• Cat litter boxes should be scooped or changed daily because oocysts require 1-5 days to become infective.
• (Mahfouz M S, Elmahdy M, Bahri A, Mobarki Y M, Altalhi A A, Barkat N A, Al-Essa H A, einAgeely A H, Faqeeh N A, Areeshi N A, Al-Hassan S M. Knowledge and attitude regarding toxoplasmosis among Jazan University female students. Saudi J Med & Med Sci.2019 : 7 : 28-32)
![Page 42: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/42.jpg)
REFERENCES• 1. Montoya J M. Toxoplasmosis. Lancet. 2009; 363:1965-76.
• 2. Zaharopoulos P. Demonstration of Parasites in Toxoplasma
Lymphadenitis by Fine-Needle Aspiration Cytology: Report of Two
Cases. Diagn Cytopathol 2000;22:11-5.
• 3. Paul M. Use of the ISAGA method in detection of specific IgM, IgA,
IgE antibodies in aquired and congenital toxoplasmosis. Wiad
Parazytol 1997;439:39-51.
![Page 43: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/43.jpg)
REFERENCES• 4.Jones J L. Toxoplasma gondi infection in the United States, decline
from the prior decade. Am j Trop Med Hyg. 2007; 77:405-10.
• 5.Hill D, Dubey JP. Toxoplasma gondii: transmission, diagnosis and
prevention. Clin Microbiol Infect. 2002;8:634–640.
• 6.Remington JS, McLeod R, Thulliez P, Desmonts G. Toxoplasmosis.
In:Remington JS, Klein J, eds. Infectious diseases of the fetus and
newborn infant. 5th ed. Philadelphia: W.B. Saunders, 2001:205–346.
![Page 44: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/44.jpg)
REFERENCES
• 7. Darweesh N.H., Hussein R.A., Salman S.T. and Shaker M.J.. “Immunological and Molecular study of Toxoplasma gondiifromaborted women in Diyala / Iraq”. Sci. J. Med. Res. 2018, 2 (6): 75-82.
• 8. Rashno M M, Fallahi S, Arab-Mazar Z, Dana H. Seromolecularassess of toxoplasma gondii infection in pregnant women and neonatal umbilical cord blood. EXCLI Journal 2019;18:1-7.
• 9. Mahfouz M S, Elmahdy M, Bahri A, Mobarki Y M, Altalhi A A, BarkatN A, Al-Essa H A, ein Ageely A H, Faqeeh N A, Areeshi N A, Al-Hassan S M. Knowledge and attitude regarding toxoplasmosis among JazanUniversity female students. Saudi J Med & Med Sci.2019 : 7 : 28-32.
![Page 45: Cytology as a tool in diagnosis of Toxoplasmosiscpo-media.net/ECP/2019/Congress-Presentations/169/toxop... · 2019-10-14 · Cytology as a tool in diagnosis of Toxoplasmosis Kausalya](https://reader033.fdocuments.in/reader033/viewer/2022041601/5e30af32a4747d67d66bbf0b/html5/thumbnails/45.jpg)
THANK U