Congenital Toxoplasmosis: Causes, Symptoms, And Treatment

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Congenital toxoplasmosis is a parasitic infection that manifests as a group of symptoms in an unborn child caused by a parasite called Toxoplasma gondii (1). The infection typically spreads from the mother to the infants while they are still in the womb. Mostly, the infection in the mother is mild, and she may be unaware of the infection. However, neonates born to infected mothers may experience serious complications as a result of this infection.

Read this post to learn more about the causes, symptoms, diagnosis, treatment, and prevention of congenital toxoplasmosis.

Causes Of Congenital Toxoplasmosis

A mother may get infected by the parasite while handling or consuming undercooked meats. One may also accidentally ingest the parasite from unwashed hands, especially after handling excrements of pet animals. Once inside the mother’s body, the parasites cross the placenta and infect the baby in the womb (2).

Maternal transmission of infection during the first trimester of pregnancy is relatively low at about 15 to 20 percent (3). If the mother gets infected later in the pregnancy, the rate of transmission to the fetus is high at about 60 percent. However, fetuses who get infected early in the pregnancy develop a severe form of the disease. About 30 to 40 percent of women infected by toxoplasmosis will have a congenitally infected child (4).

Symptoms Of Congenital Toxoplasmosis

About half of all babies born infected with toxoplasmosis before birth are born prematurely. The signs of infections are evident at birth in most cases. However, in babies with mild infections, there are no symptoms for months or years after birth. Undiagnosed and untreated infections may cause problems when the children reach their teenage years. The infection can cause problems with the eyes, nervous system, skin, and ears.

The following are the symptoms of congenital toxoplasmosis in babies (1).

  • Premature birth
  • Enlarged liver
  • Enlarged spleen
  • Vomiting
  • Inflammation of the retina or other parts of the eye leading to eye damage
  • Feeding problems
  • Yellowish discoloration of skin or jaundice
  • Intrauterine growth restriction or low birth weight
  • Tiny red spots, bruises, or skin rash at birth
  • Myocarditis
  • Pneumonitis
  • Seizures
  • Intellectual disabilities

Diagnosis Of Congenital Toxoplasmosis

The pediatrician will begin with a physical examination and may look for the following signs (2).

  • Enlarged liver or spleen
  • Yellow discoloration of the skin
  • Inflammation of the eyes
  • Fluid accumulation in the brain (hydrocephalus)
  • Swollen lymph nodes
  • Larger or smaller than normal head size

The following tests may be performed during pregnancy.

  • Amniotic fluid testing
  • Fetal blood testing
  • Antibody titer
  • Abdominal ultrasound

After birth, the following tests are usually done.

  • MRI scan of the brain
  • Neurological exams
  • Eye examination
  • Toxoplasmosis test

Treatment For Congenital Toxoplasmosis

The following treatment plan is usually followed for the treatment of toxoplasmosis (4).

  • In pregnant mothers, spiramycin is used to treat toxoplasmosis.
  • Pyrimethamine and sulfadiazine is used to treat fetal infections
  • Pyrimethamine, sulfadiazine, and leucovorin may be used for a year for the treatment of infants with congenital toxoplasmosis.
  • Infants may also be administered steroids if they have problems with vision or have elevated protein levels in the spinal fluid.

Prevention Of Congenital Toxoplasmosis

According to the US Centers for Disease Control and Prevention, the following measures can help in preventing congenital toxoplasmosis (5).

  • Pregnant women or women trying to conceive can get themselves tested to check if they are infected or are at risk of infection.
  • Pregnant women with cats as house pets should avoid contact with cat litter and things that may be contaminated by cockroaches and flies exposed to the cat feces.
  • They should avoid raw meat and must only eat well-cooked meat.
  • They must wash their hands well after handling raw meat.
  • They must wear gloves while gardening.
  • Ensure proper hand-washing every time.

Contact your healthcare provider if you are pregnant and suspect that you are at risk of infection. If you have not received any prenatal care, you must inform your doctor at the time of delivery.

Prognosis Of Congenital Toxoplasmosis

The outcome of congenital toxoplasmosis depends on the severity of the situation. While some babies might suddenly succumb to the infection, others may have lifelong neurological issues. In rare cases, neurological symptoms, such as chorioretinitis, intellectual disability, deafness, and seizures, might develop years later in children who appear normal at birth. About 80 percent of babies born with congenital toxoplasmosis develop learning or visual disabilities later in life (6). Therefore, children born with congenital toxoplasmosis must be closely monitored even after their neonatal period.

Frequently Asked Questions

1. Is congenital toxoplasmosis fatal?

Yes, congenital toxoplasmosis has been indicated as a significant cause of morbidity and mortality. It is more so in developing countries with warmer climates and not-so-well-established medical infrastructure. However, proper antenatal treatment has been successful in making the outcomes mild (7).

2. How many babies are born with congenital toxoplasmosis?

In the United States, cases of congenital toxoplasmosis have been estimated to range from one in 3,000 to one in 10,000 live births (8).

Congenital toxoplasmosis is a parasite infection that can cause serious health consequences if left untreated. The infection may spread from cat litter, uncooked meat, or handling raw meat. Mild infections may go unnoticed in the mother but may seriously affect babies. The infection raises the chances of fetal distress, liver malfunction, and premature birth. It is essential to be cautious about preventing toxoplasmosis during pregnancy to save the fetus from being affected. If your baby is being diagnosed with congenital toxoplasmosis, it’s essential to promptly start the treatment and complete its entire course as suggested by your doctor.

Key Pointers

  • Congenital toxoplasmosis is caused by a parasite called Toxoplasma gondii that passes from the mother to the infant in the womb.
  • Premature birth, enlarged liver, vomiting, feeding problems, and seizures are some symptoms of this condition.
  • Diagnostic tests to detect the problem may be done during pregnancy or after the baby’s birth.
  • Regular testing of pregnant women, avoiding the consumption of raw meat, and washing hands properly after touching raw meat are some ways to prevent the condition.

References:

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Dr. Ritika Shah

Dr. Ritika Shah is a certified lactation counsellor from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate... more

Maria Carmela Villania-Mamauag

(MD, DPPS)
Maria Carmela Villania-Mamauag is a board certified diplomate of the Philippine Pediatric Society with a degree of Doctor of Medicine from Our Lady of Fatima University, Valenzuela City and a Bachelor in Science in Psychology from Saint Louis University, Baguio City which was augmented by a year of Bachelor in Science in Family Life and Child development at the University... more

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