Health Encyclopedia

Congenital toxoplasmosis

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:

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

Calling your health care provider

Call for an appointment with your health care provider if you are pregnant and think you are at risk for toxoplasmosis (for example, if you have a cat and are the person who cleans the litter box).

Call for an appointment with your health care provider if you are pregnant and have not received any prenatal care.

Prevention

Prospective or expectant mothers can be tested to find out if they are at risk for toxoplasmosis.

Pregnant women who have cats as house pets may be at increased risk of developing toxoplasmosis. They should avoid contact with any materials that are potentially infected with cat feces, or that could be contaminated by insects exposed to cat feces (cockroaches, flies, etc.).

Cook meat until it is well done, and wash your hands after handling raw meat.

References

Cohen J, Powderly WG. Infectious Diseases. 2nd ed. New York, NY: Elsevier; 2004.

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005.

Review Date:11/12/2007
Reviewed By:Rachel A. Lewis, M.D., F.A.A.P., Columbia University Pediatric Faculty Practice, New York, NY. Review provided by VeriMed Healthcare Network.

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