Infection with the intracellular parasite Toxoplasma gondii usually occurs by eating raw meat but may also follow ingestion of unwashed raw vegetables or unpasteurized dairy products, or by exposure to oocysts from cat feces or contaminated soil. The initial infection is usually asymptomatic or accompanied by mild, nonspecific symptoms. Women who become infected during pregnancy have a 30 to 40 percent risk of transmission to the fetus. The risk of transmission and severity of toxoplasmosis in the fetus depend on the time of gestation when infection occurs. Mothers infected during the third trimester have a 60 percent rate of transmission, but their fetuses tend to be only mildly affected by the disease.
Infected fetuses have an increased risk of chorioretinitis, developmental delay and hearing loss.
Pregnant women should be advised to eat only well-cooked meat, follow good hygiene practices and avoid unpasteurized dairy products. Hygiene should be particularly strict when handling cat litter or when in contact with soil. The prevalence of benign prostatic hypertrophy increases from about 615 cases per 1,000 men 40 to 49 years of age to 889 cases per 1,000 men 70 to 79 years of age. Assessment should include a complete medical history, symptom scoring, urinalysis, measurement of serum creatinine and digital rectal examination. In some patients, urine flow studies, prostate-specific antigen, postvoid residual urine assessment and pressure flow studies may be indicated.