Toxoplasmosis Acquired in French Guiana in Immunocompetent Adults: Case Series From 2002 to 2019, With a Focus on Outpatients

Abstract Background Amazonian toxoplasmosis is classically associated with severe disease in hospitalized adults. However, little is known about milder outpatient forms in French Guiana. Methods We retrospectively analyzed 174 immunocompetent adults diagnosed with acute toxoplasmosis in French Guiana (2002–2019), comparing clinical and laboratory features between hospitalized (HPs) and outpatient (OPs) cases. Results Seventy-four patients (43%) were OPs. Fever (93%), lymphadenopathy (62%), and digestive symptoms (56%) predominated among OPs, while respiratory symptoms, anemia, and hyponatremia predicted hospitalization (aOR 9.8, 3.9, and 5.4, respectively). Parasitaemia was detected in 27% of OPs but genotyping succeeded only in HPs, all infected by Toxoplasma gondii strains of the Amazonian population. Conclusions Mild parasitaemic forms of toxoplasmosis occur in immunocompetent adults in French Guiana. The clinical spectrum of toxoplasmosis in French Guiana appears broader than previously described, extending beyond the severe forms typically associated with strains of the Amazonian population.