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Recent knowledge of host cell-parasite interactions and of parasite virulence has brought new insights into the comprehension of the pathophysiology of infection.
In this review, we focus on epidemiological and diagnostic aspects, putting them in perspective with current knowledge of parasite genotypes.
They are limited by a complex membrane, named the pellicle, closely associated with a cytoskeleton involved in the structural integrity and motility of the cell.
They possess a nucleus, a mitochondrion, a Golgi complex, ribosomes, an endoplasmic reticulum, and a multiple-membrane-bound plastid-like organelle called the apicoplast, the result of a possible acquisition by the parasite via a secondary endosymbiosis of a free-living red alga (285).
After the ingestion of cysts present in tissues of an intermediate host, the cyst wall is destroyed by gastric enzymes.
INSERM U1094, Tropical Neuroepidemiology, Limoges, France, Université Limoges School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, Limoges, France, and CNRS FR 3503 GEIST, CHU Limoges, Limoges, France was discovered a little over 100 years ago, but knowledge of its biological life cycle and its medical importance has grown in the last 40 years.
This obligate intracellular parasite was identified early as a pathogen responsible for congenital infection, but its clinical expression and the importance of reactivations of infections in immunocompromised patients were recognized later, in the era of organ transplantation and HIV infection.
Cysts remain intracellular throughout their life span.
The death of the host cell may trigger the disruption of the cyst wall and the consequent liberation of bradyzoites.