Congenital toxoplasmosis is a group of symptoms that occur when an unborn baby (fetus) is infected with the parasite Toxoplasma gondii.
Causes, incidence, and risk factorsThe fetus can become infected with toxoplasmosis if the mother becomes infected with toxoplasmosis during the pregnancy. The infection may spread to the fetus during the pregnancy itself, or during labor or delivery.
For the mother, the toxoplasmosis infection is generally mild, and she may not be aware of it. Infection of the fetus, however, can cause severe problems. Infection early in pregnancy results in more severe problems than later infection.
SymptomsUp to half of the fetuses who become infected with toxoplasmosis during the pregnancy ae born early (prematurely). Congenital toxoplasmosis can damage the baby's eyes, nervous system, skin, and ears.
Often, there are signs of infection in the baby at birth. However, newborns with milder infections may not have symptoms or problems for months or even years. If they are not treated, almost all develop problems (especially in the eyes) when they become adolescents.
Symptoms may include:
Brain and nervous system damage may be severe or very mild, and may include:
The physical examination may show signs of:
Signs and symptoms that occur late in the disease include:
Prenatal tests include:
Postnatal diagnosis:
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.
ComplicationsCall 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.
PreventionProspective 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.
ReferencesRemington JS, McLeod R, Thulliez P, Desmonts G. Toxoplasmosis. In: Remington JS. Infectious Diseases of the Fetus and Newborn Infant. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2006: chap 31.
Congenital toxoplasmosis may cause visual impairment and hearing loss.
"Parasitology; Preventive Practices Eliminate the Risk for Congenital Toxoplasmosis." Health and Medicine Week May 3, 2004: 715.
Congenital toxoplasmosis may cause seizures, mental retardation or other neurological problems months or years after birth.
Maternal treatment with spiramycin for toxoplasmosis infection occurring within the first two weeks of pregnancy prevents transmission to the fetus. The prognosis for congenital toxoplasmosis depends on its severity.
Postnatal diagnosis for congenital toxoplasmosis may include antibody tests of the cord blood and cerebrospinal fluid; an ophthalmologic examination; neurological examinations; and, a computed axial tomography (CT or CAT) scan.
Retinal damage in infants can be caused by conditions such as retinopathy of prematurity (ROP), infections like congenital toxoplasmosis or cytomegalovirus, genetic disorders, or trauma during birth. It is important for infants to receive regular eye exams to monitor for any signs of retinal damage.
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* John Doe is a congenital liar (born liar). * Joe Bloggs has six fingers: it is a minor congenital deformity.
"Congenital" means present at birth. So, a congenital heart defect is a defect (structural anomaly) that is present at birth. 1 in 100 babies are born with a congenital heart defect.
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A congenital disease is one that is present at birth.
Congenital means existing from birth. A congenital spinal defect is a spinal defect that a person is born with, such as, for instance, Spina Bifida. Spina Bifida is not the only congenital spinal defect that exists.