I can find mountains of information on how to avoid catching toxoplasmosis, but hardly anything on what to do when you were born with it. I'm a 55-year-old man infected since birth. Mistreatment of repeated infections resulted in a detached retina that had punctured in several places. Surgery has corrected this problem. What can be done to control this infection? Can it be cured? I live in the United Kingdom. Does the United States have more advanced information and/or treatment?

I.

You have asked some very difficult questions. Let me start by addressing the easier ones. First, the United Kingdom should have the same information as the United States in regard to toxoplasmosis, and I would not expect the care to necessarily be better in the United States.

Second, toxoplasmosis is an infection by organisms called protozoa. A person gets the infection through exposure to cat feces or eating poorly cooked meats. It can also be acquired in the womb if a woman is infected while pregnant. Toxoplasmosis infection in adults is usually a self-limited syndrome similar to mono (infectious mononucleosis). It can cause more serious problems if the patient has an underlying illness that weakens the immune system, such as HIV infection.

When toxoplasmosis is acquired before birth, two things can happen. First, the baby can be born with severe problems that can be permanently disabling or even fatal. Much more commonly, the baby is normal, with no signs of disease. Later in life, though, the person can develop a protozoal infection of the light-sensitive retina in the eye ("retinitis").

In some people, the retinal infection does not cause problems and is found incidentally when the patient has an eye exam. Others have a severe infection that causes diminished vision. The infection can be treated with a course of antibiotics, and most patients will never have a problem again. The disease is not exactly cured, because living but inactive protozoa persist in the body for a long time after treatment. In a few cases, active disease does recur, but it can usually be treated successfully with a second course of antibiotics.

In other patients -- and you may fall into this category -- the infection is successfully treated, but the damaged retina becomes partially or completely detached from the eyeball. Since the disease is already inactive, further antibiotic treatments will not help to treat this sight-threatening complication.

Ask your ophthalmologist if he or she thinks you still have an active eye infection, or if all your problems are related to the late complications of a treated infection. If the doctor thinks your infection is still active, ask whether further antibiotic therapy will be beneficial.