Congenital toxoplasmosis Health Article

Definition

Congenital toxoplasmosis is a group of symptoms caused by infection of the unborn baby (fetus) with the parasite Toxoplasma gondii.

Causes, incidence, and risk factors

The fetus can become infected with toxoplasmosis if the mother is infected with toxoplasmosis, or if she has a history of toxoplasmosis during previous pregnancies.

For the mother, the disease is generally mild and may not be evident. Infection of the fetus, however, can cause severe problems. Infection early in pregnancy results in more severe problems than later infection.

Symptoms

Congenital toxoplasmosis can damage the baby's eyes, nervous system, skin, and ears.

Symptoms include:

• Anemia
• Enlarged liver and spleen
• Eye damage from inflammation of the retina
• Jaundice
• Low birth weight
• Prematurity
• Skin rash (petechiae or ecchymosis) at birth

Signs and tests

The physical examination may show signs of:

• Anemia
• Cerebral calcifications
• Chorioretinitis
• Hydrocephalus
• Lymphadenopathy
• Macrocephaly or microcephaly

Signs and symptoms that occur late in the disease include:

• Hearing loss
• Mental retardation
• Seizures
• Neurological problems
• Visual impairment

Prenatal tests include:

• Amniotic fluid testing and fetal blood testing
• Antibody titer
• Ultrasound of the abdomen

Postnatal diagnosis:

• Antibody studies on cord blood and cerebrospinal fluid
• CT scan of the brain
• MRI scan of the brain
• Neurological exams
• Standard eye exam
• TORCH screen

Treatment

Spiramycin can treat infection in the pregnant mother.

Pyrimethamine and sulfadiazine can treat fetal infection (diagnosed during the pregnancy).

Treatment of infants with congenital toxoplasmosis typically includes pyrimethamine, sulfadiazine, and leucovorin for one year. Infants are also sometimes given steroids if their vision is threatened or if the protein level in the spinal fluid is high.

Expectations (prognosis)

The outcome depends on the severity of the congenital toxoplasmosis.

Complications

• Blindness or severe visual disability
• Severe mental retardation or other neurological problems