Toxoplasmosis, congenital

Toxoplasmosis, congenital
Toxoplasma gondii tachyzoites
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Congenital toxoplasmosis is an infection caused by the protozoan parasite Toxoplasma gondii that is transmitted from an infected mother to her fetus during pregnancy. This condition can lead to serious health problems in the newborn, including neurological and ocular complications.

Pathophysiology

Congenital toxoplasmosis occurs when a pregnant woman becomes infected with Toxoplasma gondii and the parasite crosses the placenta to infect the fetus. The risk of transmission and the severity of the disease depend on the timing of the maternal infection during pregnancy. Early infections in the first trimester are less likely to result in transmission but can cause more severe outcomes, while infections later in pregnancy are more likely to be transmitted but often result in milder disease.

Clinical Manifestations

The classic triad of symptoms associated with congenital toxoplasmosis includes:

• Chorioretinitis: Inflammation of the choroid and retina, which can lead to vision problems.
• Hydrocephalus: Accumulation of cerebrospinal fluid in the brain, causing increased intracranial pressure.
• Intracranial calcifications: Calcium deposits in the brain, detectable by imaging.

Other symptoms may include seizures, jaundice, hepatosplenomegaly, and lymphadenopathy. Long-term complications can include developmental delay, hearing loss, and vision problems.

Diagnosis

Diagnosis of congenital toxoplasmosis can be challenging. It often involves a combination of serological tests to detect specific antibodies in the mother and the newborn, as well as polymerase chain reaction (PCR) testing to identify the parasite's DNA in amniotic fluid or neonatal blood. Prenatal diagnosis can be performed through amniocentesis.

Prevention

Preventive measures for congenital toxoplasmosis focus on reducing the risk of maternal infection. These include:

• Avoiding consumption of undercooked or raw meat.
• Washing hands thoroughly after handling raw meat.
• Avoiding contact with cat litter, as cats are the definitive hosts of Toxoplasma gondii.
• Washing fruits and vegetables thoroughly before consumption.

Treatment

Treatment of congenital toxoplasmosis typically involves a combination of pyrimethamine, sulfadiazine, and folinic acid. This regimen helps to reduce the severity of symptoms and prevent further complications. Early treatment is crucial for improving outcomes.

Epidemiology

The prevalence of congenital toxoplasmosis varies widely by region, influenced by factors such as dietary habits, climate, and the prevalence of the parasite in the environment. It is more common in areas where raw or undercooked meat is frequently consumed.

Also see

• Toxoplasmosis
• Chorioretinitis
• Hydrocephalus
• Intracranial calcification