Congenital toxoplasmosis

Abstract

Toxoplasma gondii, one of the most prevalent zoonotic parasites globally, may be transmitted to the fetus if a primary infection occurs during pregnancy. The earlier the gestational period, the lower the probability of transmission, but if it occurs, the higher the probability of pregnancy loss or severe fetal neurological or ocular damage. Primary prevention measures to pregnant women include avoiding eating or handling raw or undercooked meat, washing hands thoroughly after gardening, avoid handling contaminated soil or water or come in contact with cat feces. The infected fetus may exhibit a broad spectrum of clinical manifestations, ranging from death in utero, stillbirths, symptomatic neonatal forms with systemic involvement and/or severe and irreversible ocular or neurological damage, to asymptomatic forms. Neurological manifestations include macro- or microcephaly, hydrocephalus, intracranial calcifications, abnormal muscle tone, cerebral palsy, global developmental delay, sensorineural hearing loss, and epilepsy. The whole clinical picture of each patient with congenital toxoplasmosis depends on a variable combination of different factors including: (a) gestational age at which the maternal infection has occurred and transmitted to the fetus, (b) disease detection: were pregnant women systematically screened during pregnancy, and if so, the frequency of serological tests, (c) if infected pregnant women and neonates were treated and timing and doses of the anti-T. gondii drugs used, (d) differences in the parasite load and in virulence of the genotype of the implicated T gondii strains, (e) individual maternal immune response, and f) presence of specific clinical features such as ventriculomegaly, multiple calcifications and retinochoroiditis.