Toxoplasma gondii actively infects circulating immune cells, including monocytes and DCs, and is thought to use these cells as Trojan horses for parasite dissemination. To investigate the interactions of T. gondii-infected human monocytes with vascular endothelium under conditions of shear stress, we developed a fluidic and time-lapse fluorescence microscopy system. Both uninfected and infected monocytes rolled, decelerated, and firmly adhered on TNF-α-activated endothelium. Interestingly, T. gondii-infected primary human monocytes and THP-1 cells exhibited altered adhesion dynamics compared with uninfected monocytes: infected cells rolled at significantly higher velocities (2.5- to 4.6-fold) and over greater distances (2.6- to 4.8-fold) than uninfected monocytes, before firmly adhering. During monocyte searching, 29-36% of infected monocytes compared with 0-11% of uninfected monocytes migrated >10 μm from the point where they initiated searching, and these "wandering" searches were predominantly in the direction of flow. As infected monocytes appeared delayed in their transition to firm adhesion, we examined the effects of infection on integrin expression and function. T. gondii did not affect the expression of LFA-1, VLA-4, or MAC-1 or the ability of Mn(2+) to activate these integrins. However, T. gondii infection impaired LFA-1 and VLA-4 clustering and pseudopod extension in response to integrin ligands. Surprisingly, a single intracellular parasite was sufficient to mediate these effects. This research has established a system for studying pathogen modulation of human leukocyte adhesion under conditions of physiological shear stress and has revealed a previously unappreciated effect of T. gondii infection on ligand-dependent integrin clustering.