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Maternal serologic screening for toxoplasmosis.

Congenital toxoplasmosis is a rare, but potentially serious, problem during pregnancy. Toxoplasmosis is caused by a protozoal parasite that can be found in warm-blooded animals (including humans); dried cat feces, contaminated soil, or contaminated water; and raw or undercooked meat containing infective tissue cysts. Although cats play a role in the epidemiology of the disease, there is no statistical correlation between toxoplasmosis infection and cat ownership. Toxoplasmosis can be transmitted to the fetus in utero through transplacental transmission. Both the incidence of placental transmission and severity of congenital disease depend on gestational age at which maternal seroconversion occurs. Although transmission rates from mother to fetus tend to be low early in pregnancy, fetal disease severity is highest when the fetus is infected early in gestation. Serological tests to determine maternal seroconversion are available, but their use can pose ethical and practical dilemmas. Universal maternal screening is not currently warranted in the United States because disease prevalence is low.

Animals↗

[Clinico-roentgenologic studies in toxoplasmosis patients with various endocrine diseases].

The authors present clinical and roentgenological characteristics of toxoplasmosis revealed in 46 of 128 patients with neuro-endocrine form of diencephalic syndrome, cerebro-hypophyseal nanism and hypogenitalism, examined for toxoplasmosis. Congenital toxoplasmosis was found in 29 and chronic acquired--in 17 cases. It was noted that the clinical picture of both the congenital and of the chronic acquired toxoplasmosis in patients with endocrine diseases was varied due to affection of different organs and systems of the organism. Of great significance in the complex clinico-laboratory diagnosis of congenital and chronic acquired toxoplasmosis was the roentgenological method of study. Roentgenological changes in the skull of the patients with endocrine diseases and toxoplasmosis were expressed in the presence of calcifications of various shape and size (from 2 mm to 2 cm), calcification of the dura mater in the frontal portion and the area of the sella turcica, and hyperostosis. Diagnosis of congenital and chronic acquired toxoplasmosis in patients with endocrine disturbances should be based on the results of complex clinico-roentgenological and laboratory studies.

Adolescent↗

[Real-time quantitative PCR for toxoplasmosis diagnosis].

Congenital toxoplasmosis results from foetus contamination by Toxoplasma gondii during pregnancy. It is a frequent and severe condition calling for close monitoring of mothers at risk. During the last decades, numerous advances have been made specially in the antenatal diagnosis. The congenital toxoplasmosis diagnosis relies currently on PCR test of amniotic fluid, with a sensitivity of 80%. More recently, real-time quantitative PCR has been developed to improve toxoplasmosis diagnosis. We therefore compared the diagnosis value of quantitative real-time PCR with our conventional PCR-hybridization for the diagnosis of congenital toxoplasmosis.

Amniotic Fluid↗

Diagnosis and management of toxoplasmosis.

This article discusses the diagnosis and management of toxoplasmosis. Congenital toxoplasmosis continues to be a tragic outcome of a preventable and treatable infection. Education of patients, physicians and health policy makers on the primary and secondary preventive measures of the disease, and their execution, will undoubtedly result in lower incidence, morbidity, and mortality rates from congenital disease due to Toxoplasma gondii.

Animals↗

[Prevention and treatment of materno-fetal toxoplasmosis].

Preventing congenital toxoplasmosis is fundamental, and in France screening tests for primary infection are obligatory for pregnant women. All nonimmunized women should be encouraged to follow good dietary and general health rules until delivery. Nevertheless, the risk of seroconversion does exist but can be detected early through monthly serum tests. Spiramycin as initial treatment of maternal primary infection is an essential step in preventing parasite transmission to the fetus. Fetal antitoxoplasmosis antibodies and indirect signs of congenital abnormalities should be detected early by amniotic fluid and fetal blood tests before echographic evidence confirms the diagnosis. Pyrimethamine-sulfonamide therapy should be undertaken and modulated according to laboratory results in order to prevent or treat any possible fetopathy. Congenital toxoplasmosis can be prevented in utero through biological diagnosis and specific therapy.

Adult↗