Thèse soutenue

Approche épidémiologique, clinique et biologique des formes sévères de toxoplasmose acquise du sujet adulte immunocompétent en Guyane française
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Auteur / Autrice : Magalie Pierre Demar
Direction : Bernard Carme
Type : Thèse de doctorat
Discipline(s) : Biologie. Médecine. Santé
Date : Soutenance en 2009
Etablissement(s) : Antilles-Guyane

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Résumé

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This thesis in a focus on medical knowledge and scientific work which helped to describe since 1998 a special from of acquired toxoplasmosis especially reported in French Guiana and in a Surinamese border village. It presents as a clinical and pathophysiological approach of criteria of pathogenicity of Toxoplasma gondii that circulate in French Guiana. The document is organized into three main parts ; the first one reports the clinical, epidemiological and biological features of this form of toxoplasmosis, called Amazonian toxoplasmosis or AT ; the second part develops the arguments for the existence of a forest base cycle of atypical strains of T. Gondii, and the third part determines the virulence criteria on mice for one T. Gondii involved in AT. General review of published articles associated with the analysis of 35 cases of AT reported from 2002 to 2009 clearly highlight the experience of this clinical entity that is remarkable for its morbidity and its clinical heterogeneity. Ethnicity, place of residence and some biological parameters seems to be aggravating factors. The initial hypothesis that AT involves unsuitable T. Gondii strains to humans led to study the circulation of the parasite in wildlife and recent studies confirms this hypothesis. The third part of this document really concretizes the virulence on mice of one atypical T. Gondii strain involved in an AT case by the determination od the letal dose, LD50 and LD100 and the description of of the histological features. This part initiates a discussion about the pathophysiolgical mechanisms of this entity