Acknowledgement of Congenital Toxoplasmosis has not been added yet.

The prevalence of congenital toxoplasmosis varies geographically and is influenced by environmental conditions, diet and hygiene practices. In low-to-moderate incidence regions such as the United States, the rate is about 1 in 10,000 to 1 in 15,000 live births. Prevalence is higher in France, parts of South America, and Eastern Europe, where infection rates range from 1 in 3,000 to 1 in 5,000 live births. The actual incidence may be underreported due to asymptomatic cases and inadequate screening.

Name	Abbreviation
Maternal-fetal Toxoplasmosis
Toxoplasma Embryofetopathy

Congenital toxoplasmosis is caused by Toxoplasma gondii, a protozoan parasite that replicates within mammalian cells. Transmission occurs when a pregnant woman contracts the infection and the parasite crosses the placenta to infect the developing fetus. The infection can be from consuming food, or exposure to cat litter or soil containing T. gondii cysts. Poor hygienic practices, such as eating unwashed produce or undercooked meat can facilitate transmission. The risk to the fetus is greatest during the third trimester, but severity is generally greater if the infection occurs earlier in pregnancy.

Symptoms of congenital toxoplasmosis can vary significantly, with some infants showing no symptoms at birth while others experience severe complications. The disease's severity is influenced by the timing of maternal infection and whether the infection is treated.

• Immediate Neonatal Symptoms:

  • Hepatosplenomegaly (enlarged liver and spleen)

  • Jaundice

  • Low birth weight

  • Petechial rash (red, brown spots under the skin)

  • Neurological complications (e.g., seizures)

  • Intrauterine growth restriction (IUGR)

  • Hydrocephalus (fluid buildup in the brain)

• Long-term Neurological and Developmental Complications:

  • Microcephaly (abnormally small head)

  • Intracranial calcifications

  • Cognitive impairments and developmental delays

  • Intellectual disabilities

  • Epilepsy

  • Motor skill deficits

  • Hearing loss

• Ocular Complications:

  • Chorioretinitis (eye inflammation)

  • Vision impairment, potential blindness

  • Retinal scarring and strabismus (crossed eyes)

Diagnosis of congenital toxoplasmosis involves a combination of prenatal and neonatal tests:

• Prenatal Diagnostic Techniques:

  • Serological testing for maternal Toxoplasma antibodies

  • PCR (Polymerase chain reaction) testing for Toxoplasma DNA in amniotic fluid

  • Ultrasound imaging for detecting potential fetal abnormalities

  • Amniocentesis to test fetal tissue

• Neonatal Diagnostic Approaches:

  • Comprehensive physical examination

  • PCR testing for Toxoplasma DNA and serological testing for Toxoplasma antibodies in blood or cerebrospinal fluid (CSF)

  • Neuroimaging (CT or MRI) to assess brain damage such as intracranial calcifications or hydrocephalus

  • Ophthalmological exams to detect chorioretinitis

  • Hearing and visual screening

The diagnosis is confirmed in infants by the persistence of Toxoplasma IgG antibodies beyond 12 months of age, and ongoing evaluations to monitor developmental progress.

Diagnostic tests of Congenital Toxoplasmosis has not been added yet

Treatment for congenital toxoplasmosis generally involves antiparasitic medications, with a focus on reducing the severity of symptoms and preventing long-term complications. The main treatment options include:

• Antiparasitic Medications:

  • Pyrimethamine and Sulfadiazine: These medications work by inhibiting the parasite’s reproduction.

  • Leucovorin: Used to prevent bone marrow suppression, a potential side effect of pyrimethamine..

  • Spiramycin: May be used in certain cases, especially when infection is diagnosed during pregnancy, to reduce the risk of transmission to the fetus. This drug is not approved for use in the U.S.

• Supportive Care:

  • Management of complications such as seizures, developmental delays, and hearing loss, including physical therapy, hearing aids, and other rehabilitative therapies.

  • Corticosteroids for inflammation management in severe cases.

The standard treatment duration is typically 12 months, depending on the severity of the condition.

Monitoring:

Long-term monitoring is essential to track the development of neurological, ocular, and other systemic complications:

• Early Childhood Monitoring:
  Frequent neurological assessments and developmental milestone tracking

  • Regular ophthalmological examinations to detect and manage chorioretinitis.

  • Hearing evaluations and neuroimaging follow-ups (CT or MRI) to monitor for brain changes, such as hydrocephalus or calcifications.

• Adolescent and Adult Monitoring:

  • Ongoing cognitive function and neuropsychological evaluations.

  • Continued eye care to address potential vision complications.

  • Management of chronic health issues that may arise, such as intellectual disabilities or epilepsy.

The prognosis of congenital toxoplasmosis depends on the timing of maternal infection, the severity of the initial infection, the promptness of diagnosis and treatment, and the child’s immune response. Early detection and treatment can significantly improve the chances of a better long-term outcome, reducing the risk of severe neurological damage and enhancing quality of life. However, without intervention, congenital toxoplasmosis can lead to lifelong disabilities, including intellectual impairment, blindness, and hearing loss.

Tips or Suggestions of Congenital Toxoplasmosis has not been added yet.

1. Montoya, J. G., & Liesenfeld, O. (2004). "Toxoplasmosis." The Lancet, 363(9425), 1965-1976. doi: 10.1016/S0140-6736(04)16412-X. PMID: 15194258.

2. Kieffer, F. & Wallon, M.. (2013). "Congenital Toxoplasmosis.” Handb Clin Neurol, 112:1099-1101. doi: 10.1016/B978-0-444-52910-7.00028-3. PMID: 23622316.

3. Torgerson, P. R. & Mastroiacovo, P. (2013). "The Global Burden of Congenital Toxoplasmosis: A Systematic Review." Bulletin of the World Health Organization, 91(7), 501-508. doi: 10.2471/BLT.12.111732. Epub 2013 May 3. PMID: 23825877; PMCID: PMC3699792.

4. Cleveland Clinic.(2022). "Toxoplasmosis:  Causes, Symptoms, Diagnosis and Treatment." Toxoplasmosis.

Centers for Disease Control and Prevention (CDC). (2024). Clinical Care of Toxoplasmosis.