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Congenital toxoplasmosis
Congenital toxoplasmosis is a group of symptoms that occur when an unborn baby (fetus) is infected with the parasite Toxoplasma gondii .
Causes
Toxoplasmosis infection can be passed to a developing baby if the mother becomes infected while pregnant. The infection spreads to the developing baby across the placenta. Most of the time, the infection is mild in the mother. The woman may not be aware she has the parasite. However, infection of the developing baby can cause serious problems. Problems are worse if the infection occurs in early pregnancy.
Symptoms
Up to half babies who become infected with toxoplasmosis during the pregnancy are born early (prematurely). The infection can damage the baby's eyes, nervous system, skin, and ears.
Often, there are signs of infection at birth. However, babies with mild infections may not have symptoms for months or years after birth. If not treated, most children with this infection develop problems in their teens. Eye problems are common.
Symptoms may include:
- Enlarged liver and spleen
- Vomiting
- Eye damage from inflammation of the retina or other parts of the eye
- Feeding problems
- Hearing loss
- Jaundice (yellow skin)
- Low birth weight (intrauterine growth restriction)
- Skin rash (tiny red spots or bruising) at birth
- Vision problems
Brain and nervous system damage ranges from very mild to severe, and may include:
- Seizures
- Intellectual disability
Exams and Tests
The health care provider will examine the baby. The baby may have:
- Swollen spleen and liver
- Yellow skin (jaundice)
- Inflammation of the eyes
-
Fluid on the brain (
hydrocephalus
)
Hydrocephalus
Hydrocephalus is a buildup of fluid inside the skull that leads to brain swelling. Hydrocephalus means "water on the brain. "
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Swollen lymph nodes (
lymphadenopathy
)
Lymphadenopathy
Lymphofollicular hyperplasia is an increase in the size of the lymph node follicles. These follicles contain normal white blood cells called lymphoc...
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Large head size (
macrocephaly
) or smaller-than-normal head size (
microcephaly
)
Macrocephaly
Increased head circumference is when the measured distance around the widest part of the skull is larger than expected for the child's age and backgr...
ImageRead Article Now Book Mark ArticleMicrocephaly
Microcephaly is a condition in which a person's head size is much smaller than that of others of the same age and sex. Head size is measured as the ...
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Tests that may be done during pregnancy include:
-
Amniotic fluid
testing and
fetal blood testing
Amniotic fluid
Amniotic fluid is a clear, slightly yellowish liquid that surrounds the unborn baby (fetus) during pregnancy. It is contained in the amniotic sac....
ImageRead Article Now Book Mark ArticleFetal blood testing
Fetal scalp pH testing is a procedure performed when a woman is in active labor to determine if the baby is getting enough oxygen.
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Antibody titer
Antibody titer
Antibody titer is a laboratory test that measures the level of antibodies in a blood sample.
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Ultrasound of the abdomen
Ultrasound of the abdomen
Abdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...
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After birth, the following tests may be done on the baby:
-
Antibody studies on
cord blood
and cerebrospinal fluid
Cord blood
Cord blood refers to a sample of blood collected from the umbilical cord when a baby is born. The umbilical cord is the cord connecting the baby to ...
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CT scan
of the brain
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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MRI scan
of the brain
MRI scan
A head MRI (magnetic resonance imaging) is an imaging test that uses powerful magnets and radio waves to create pictures of the brain and surrounding...
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- Standard eye exam
- Toxoplasmosis test
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 most often 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.
Outlook (Prognosis)
The outcome depends on the extent of the condition.
Possible Complications
Complications may include:
- Hydrocephalus
-
Blindness
or severe visual disability
Blindness
Blindness is a lack of vision. It may also refer to a loss of vision that cannot be corrected with glasses or contact lenses. Partial blindness mean...
ImageRead Article Now Book Mark Article - Severe intellectual disability or other neurological problems
When to Contact a Medical Professional
Call your health care provider if you are pregnant and think you are at risk for the infection. (For example, toxoplasmosis infection can be passed from cats if you clean the cat's litter box.) Call your provider if you are pregnant and have not had prenatal care.
Prevention
Women who are pregnant or planning to become pregnant can be tested to find out if they are at risk for the infection.
Pregnant women who have cats as house pets may be at higher risk. They should avoid contact with cat feces, or things that could be contaminated by insects exposed to cat feces (cockroaches, flies, etc.).
Also, cook meat until it is well done, and wash your hands after handling raw meat to avoid getting the parasite.
References
American Academy of Pediatrics. Toxoplasma gondii infections (toxoplasmosis). In: Red Book: 2012 Report of the Committee on Infectious Diseases , 29th, Pickering LK. (Ed), American Academy of Pediatrics, Elk Grove Village, Ill 2012. p.720.
McLeod R. Toxoploasmosis ( Toxoplasma gondii ). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics . 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 282.
Montoya JG, Boothroyd JC, Kovacs JA. Toxoplasma gondii . In: Bennett E, Dolin R, Blaser MJ, eds. Mandell, Douglass, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2015:chap 280.
Petersen E. Toxoplasmosis. Semin Fetal Neonatal Med. 2007 Jun;12(3):214-23. PMID: 17321812 www.ncbi.nlm.nih.gov/pubmed/17321812 .
-
Congenital toxoplasmosis - illustration
Human infection with the toxoplasma gondii protozoan results from ingesting contaminated raw meat or soil, or careless handling of the contents of an infected cat's litter box. An infected pregnant woman can transmit the infection to her fetus (congenital toxoplasmosis).
Congenital toxoplasmosis
illustration
-
Congenital toxoplasmosis - illustration
Human infection with the toxoplasma gondii protozoan results from ingesting contaminated raw meat or soil, or careless handling of the contents of an infected cat's litter box. An infected pregnant woman can transmit the infection to her fetus (congenital toxoplasmosis).
Congenital toxoplasmosis
illustration
Review Date: 4/21/2015
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
