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[Prenatal diagnosis of congenital toxoplasmosis].

Primary Toxoplasmosis is devoid of any consequences in the mother in most cases, while the fetus can suffer serious damages following transplacental passage of the parasite. This is probably due to its limited immunocompetence. 440 women have been seen for suspected primary infection during pregnancy: clinical and serological parameters excluded infection in 62% of the cases. In 168 cases primary infection was likely and they underwent therapy with Spiramycin 3 grams per day to prevent placental and fetal colonization: 53 cases were elected for invasive prenatal diagnosis. Amniotic fluid was obtained by amniocentesis and fetal blood by ultrasound guided cordocentesis and by fetoscopy: the samples were analyzed for specific anti Toxoplasma IgM and sent for isolation of the parasite. Diagnosis of fetal infection was made in 4 cases: 3 cases had specific IgM in cord blood, 1 case showed intracranial calcifications by ultrasound screening. Fetal infection rate is thus below 10% and prenatal diagnosis avoids unjustified interruption of pregnancies complicated by maternal toxoplasmic infection.

Adult↗
PubMed1989

[Congenital toxoplasmosis with delayed immune response].

In typical cases the diagnosis "toxoplasmosis connata" is based on clinical symptoms and positive serological findings. When the infection of the fetus occurred a short time before birth the neonate seems still normal and the disease develops in the postnatal period. In such cases the specific antibody production may be delayed. We present a case report with well documented first infection of the mother between the 15th and 30th gestational week but with no specific treatment. The baby was born without clinical signs of a toxoplasmosis infection and developed the disease 2-3 weeks later; the serological test (complement fixation test, KBR) was negative at the 24th postnatal day. Specific antimicrobial therapy could be started after serological conversion between the 4th and 5th postnatal week. Problems of diagnostics and delayed therapy are discussed.

Animals↗