Congenital toxoplasmosis: An overview of the neurological and ocular manifestations. 2018

Khadija Khan, and Wajihullah Khan
Department of Zoology, Section of Parasitology, Aligarh Muslim University, India.

Toxoplasma gondii is an obligate intracellular parasite which is known to infect one-third of the total world population chronically though it is asymptomatic in immunocompetent patients. However, in an immunocompromised patient or an infected fetus, it may cause devastating effects. The parasite may cross the placenta of an infected pregnant woman and probably infect the fetus congenitally. The severity of the infection depends on the gestational age at which the infection has occurred i.e., if it has occurred in the early phase, the rate of transmission is low but the severity is high if the fetus is infected and if it has occurred in the later phase then transmission rate is higher while the severity would be low. Congenital toxoplasmosis may result in non-specific consequences like abortion, intra-uterine growth restriction, jaundice, hepatosplenomegaly or even intra-uterine death. It may also result in neurological or ocular manifestations like intracranial calcifications, hydrocephalus or retinochoroiditis. The diagnosis may be done by serological screening of anti-Toxoplasma antibodies (IgM and IgG) while PCR of the amniotic fluid or the placenta is the confirmatory test. Acute or chronic infections may be differentiated by IgG avidity tests. The treatment regimens include spiramycin to prevent congenital transmission from an infected mother, pyrimethamine, sulfadoxine and folinic acid to treat the infected fetus, CSF shunting for the treatment of hydrocephalus and a combination of pyrimethamine, azithromycin, and corticosteroids for treating ocular toxoplasmosis.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000981 Antiprotozoal Agents Substances that are destructive to protozoans. Schizonticides,Agents, Antiprotozoal
D014122 Toxoplasma A genus of protozoa parasitic to birds and mammals. T. gondii is one of the most common infectious pathogenic animal parasites of man. Toxoplasma gondii,Toxoplasma gondius,Toxoplasmas,gondius, Toxoplasma
D014125 Toxoplasmosis, Congenital Prenatal protozoal infection with TOXOPLASMA gondii which is associated with injury to the developing fetal nervous system. The severity of this condition is related to the stage of pregnancy during which the infection occurs; first trimester infections are associated with a greater degree of neurologic dysfunction. Clinical features include HYDROCEPHALUS; MICROCEPHALY; deafness; cerebral calcifications; SEIZURES; and psychomotor retardation. Signs of a systemic infection may also be present at birth, including fever, rash, and hepatosplenomegaly. (From Adams et al., Principles of Neurology, 6th ed, p735) Congenital Toxoplasma gondii Infection,Toxoplasmosis, Fetal,Toxoplasmosis, Prenatal,Congenital Infection, Toxoplasma gondii,Congenital Toxoplasma Infections,Congenital Toxoplasmosis,Toxoplasma Infections, Congenital,Congenital Toxoplasma Infection,Congenital Toxoplasmoses,Fetal Toxoplasmoses,Fetal Toxoplasmosis,Infection, Congenital Toxoplasma,Infections, Congenital Toxoplasma,Prenatal Toxoplasmoses,Prenatal Toxoplasmosis,Toxoplasma Infection, Congenital,Toxoplasmoses, Congenital,Toxoplasmoses, Fetal,Toxoplasmoses, Prenatal
D014126 Toxoplasmosis, Ocular Infection caused by the protozoan parasite TOXOPLASMA in which there is extensive connective tissue proliferation, the retina surrounding the lesions remains normal, and the ocular media remain clear. Chorioretinitis may be associated with all forms of toxoplasmosis, but is usually a late sequel of congenital toxoplasmosis. The severe ocular lesions in infants may lead to blindness. Ocular Toxoplasmosis,Ocular Toxoplasmoses,Toxoplasmoses, Ocular
D015597 Pregnancy Complications, Parasitic The co-occurrence of pregnancy and parasitic diseases. The parasitic infection may precede or follow FERTILIZATION. Parasitic Pregnancy Complications,Complications, Parasitic Pregnancy,Pregnancy, Parasitic Complications,Complication, Parasitic Pregnancy,Complications Pregnancies, Parasitic,Complications Pregnancy, Parasitic,Parasitic Complications Pregnancies,Parasitic Complications Pregnancy,Parasitic Pregnancy Complication,Pregnancies, Parasitic Complications,Pregnancy Complication, Parasitic
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D016036 Seroepidemiologic Studies EPIDEMIOLOGIC STUDIES based on the detection through serological testing of characteristic change in the serum level of specific ANTIBODIES. Latent subclinical infections and carrier states can thus be detected in addition to clinically overt cases. Seroprevalence,Seroepidemiologic Study,Seroepidemiological Study,Studies, Seroepidemiologic,Study, Seroepidemiologic,Seroepidemiological Studies,Seroprevalences,Studies, Seroepidemiological,Study, Seroepidemiological

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