Congenital toxoplasmosis

  • Definition
    • 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
  • 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
      • 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