Congenital Toxoplasmosis

Overview

Congenital toxoplasmosis, protozoan parasite Toxoplasma gondii It is a disease transmitted from mother to fetus in infected fetuses. It can cause miscarriage or stillbirth. It can also cause serious and progressive visual, hearing, motor, cognitive and other problems in a child.

There are approximately 400 to 4000 cases of congenital toxoplasmosis in the United States each year.

Symptoms and Complications of Congenital Toxoplasmosis

Most infected babies appear healthy at birth. They often do not develop symptoms until months, years, or even decades later.

Infants with severe congenital toxoplasmosis usually have symptoms at birth or develop symptoms within the first six months of life.

Symptoms may include:

  • preterm birth – half of babies with congenital toxoplasmosis are born prematurely
  • abnormally low birth weight
  • eye damage
  • jaundice, yellowing of the skin and whites of the eyes
  • diarrhea
  • vomiting
  • anemia
  • feeding difficulty
  • swollen lymph nodes
  • enlarged liver and spleen
  • macrocephaly, an abnormally large head
  • microcephaly, an abnormally small head
  • skin rash
  • vision problems
  • hearing loss
  • motor and developmental delays
  • hydrocephalus, fluid buildup in the skull
  • intracranial calcifications, evidence of areas of damage in the brain caused by parasites
  • seizures
  • mild to severe mental retardation

What Are the Risks of My Unborn Child Having Congenital Toxoplasmosis?

If you contract the parasites during the first trimester of pregnancy, there is a 15-20 percent chance that your baby will have congenital toxoplasmosis. However, if you become infected in the third trimester, your unborn child has a 60 percent chance of being infected, according to Boston Children’s Hospital estimates.

Causes of Congenital Toxoplasmosis

T. gondii You can get parasites in several ways:

  • by eating uncooked or undercooked meat
  • from unwashed products
  • although it is rare for the parasites to be obtained from water in the United States, by drinking water contaminated with the parasites or their eggs
  • touching contaminated soil or cat feces and then touching your mouth

If you get parasites during your pregnancy, you can pass them to your unborn child during pregnancy or delivery.

Should I Get Rid of My Cat?

You can keep your cat, even if they have parasites. to the Centers for Disease Control and Prevention Accordingly, the risk of acquiring the parasites from your cat is very low. However, have another person replace your cat’s litter box throughout your pregnancy.

How Is It Diagnosed?

Your doctor can do a blood test to detect parasites. If you test positive for the parasites, they may do additional testing during your pregnancy to determine if your unborn baby is also infected. These tests include:

  • ultrasound to check for fetal abnormalities such as hydrocephalus
  • polymerase chain reaction or PCR, amniotic fluid test, but this test may produce false negative or false positive results
  • fetal blood test

If your baby shows symptoms of congenital toxoplasmosis after birth, your doctor may do one or more of the following tests:

  • antibody test on umbilical cord blood
  • antibody test on your baby’s cerebrospinal fluid
  • blood test
  • eye test
  • neurological examination
  • CT or MRI scan of your baby’s brain

How Is It Treated?

Certain types of medication are often used to treat congenital toxoplasmosis:

Medications Given During Pregnancy

  • spiramycin or Rovamycin, to help prevent the transmission of parasites from you to your fetus
  • If your fetus is confirmed to be infected with the parasites, pyrimethamine or Daraprim and sulfadiazine may be given after the first trimester
  • Folic acid to protect you and your fetus from bone marrow loss caused by pyrimethamine and sulfadiazine
  • pyrimethamine, sulfadiazine, and folic acid are usually taken for one year.
  • steroids if your baby is at risk of vision loss or if your baby has a high level of protein in their spinal fluid

Medications Given to the Baby After Birth

In addition to medication, your doctor may recommend other treatments depending on your baby’s symptoms.

Long Term Prospects

Your baby’s long-term outlook depends on the severity of his symptoms. Parasitic infection usually causes more serious health problems in fetuses who contract early in pregnancy rather than in early pregnancy. If detected early, medications may be given before the parasites can harm your fetus. Up to 80 percent of babies with congenital toxoplasmosis will develop vision and learning difficulties later in life. Some babies may have vision loss and lesions in their eyes thirty or more years after birth.

Prevention

As an expectant mother, congenital toxoplasmosis can be prevented in the US by:

  • cook well
  • washing and peeling all fruits and vegetables
  • wash your hands often and cutting boards used for preparing meat, fruit or vegetables
  • wear gloves in the garden or avoid the garden altogether to avoid contact with the soil that can avoid cats in the garden
  • avoid replacing the litter box

Following these simple rules will help you avoid being affected by the parasites that cause toxoplasmosis and therefore cannot pass them on to your unborn child.

Resources:

Diagnosis and management of foodborne illness – a primer for physicians and other healthcare professionals. (2004, April 6)

Hughes, JM, Colley, DG, Lopez, A., Dietz, VJ, Wilson, M., Navin, TR, Jones, JL (2000, March 31). Prevention of congenital toxoplasmosis. Morbidity and Mortality Weekly Report, 49 (RR02), 57-75

Jones, J., Lopez, A., Wilson, m. (2003, May 15) Congenital toxoplasmosis. Am Fam Physician, 67 (10): 2131-2138

Stillwaggon, E., Carrier, CS, Sautter, M., McLeod, R. (2011, September 27). Maternal serological screening to prevent congenital toxoplasmosis: A Decision Analytical Economic Model. PLoS Negl Trop Dis, 5 (9): e1333

Wilson, CB, Remington, JS, Stagno, S., Reynolds, BW (1980, November). Adverse sequelae development in children born with subclinical congenital toxoplasma infection. Pediatrics, 66 (5), 767-774

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