What is Congenital Toxoplasmosis?

What is Congenital Toxoplamosis?

Congenital Toxoplasmosis is an infection caused Toxoplasma Gondii passed to the unborn baby by the infected mother. The baby could be asymptomatic at birth, as is the case with around 70% of infected babies, while the symptoms do appear eventually ranging from mild to severe (neurological issues, eye damage, hearing loss) with even stillbirth or death shortly after birth in extreme cases.

What Causes Congenital Toxoplasmosis?

The mother could be infected before or during pregnancy with Toxoplasma Gondii through one of the many routes mentioned below:

• Consuming contaminated water, fruits, vegetables, undercooked meat or raw eggs

• Working in the garden frequented by cats

• Touching contaminated soil

• Changing cat litter

The parasite could be asymptomatic or cause mild flu like symptoms upon infection in healthy mothers. In some rare cases the parasite could form cysts and stay dormant in the body for years while releasing the parasite at intervals (reactivation) which the body's immune system could fight off as long as the individual is healthy. In case of pregnant women, the parasite could enter the baby's system by crossing the placental barrier and could cause serious damage or remain asymptomatic for months, years or much later in life.

Congenital Toxoplasmosis Symptoms

Babies having congenital toxoplasmosis often are born prematurely with low birth weight. While many babies (70-80%) show no symptoms at birth, the symptoms manifest at later stages of life.

Some of the common symptoms are:

• Swollen lymph nodes

• Inflammation of the eyes

• Rashes, tiny red spots at birth

• Enlarged spleen and liver

• Jaundice

• Vomiting or Difficulty feeding

• Hearing Loss

• Anaemia

Some of the serious symptoms are:

• Blurred vision, eye pain, retinal damage, blindness

• Seizure

• Intellectual disabilities

• Hydrocephaly - Fluid in the brain

• Macro or Microcephaly

• Developmental Delays

• Facial paralysis

• Intracranial calcifications

Congenital Toxoplasmosis Diagnosis

The healthcare provider during a physical exam could notice the signs like swollen lymph nodes, spleen, liver along with other symptoms like micro or macrocephaly, hydrocephaly and yellow skin (jaundice) and suspect toxoplasmosis among other causes. To confirm the diagnosis, there are multiple tests that the healthcare provider could ask for:

• Eye exam to look for changes and damage

• Neurological exam

• CT scan of the brain

• MRI scan of the brain

• Toxoplasmosis test (Blood to detect antibodies to Toxoplasma Gondii)

• Lumbar puncture (Long needle is used to draw cerebrospinal fluid that is tested for the parasite)

Tests done during pregnancy:

If your doctor suspects Toxoplasmosis infection during pregnancy, the below tests would be done to confirm the diagnosis and to decide on next course of action

• Ultrasound: If the doctor suspects toxoplasmosis during pregnancy, the doctor may look for signs of impact on the brain through ultrasound.

• Amniocentesis: A long needle is inserted through the mother's abdomen to collect the amniotic fluid, which is then tested for the infection.

• Fetal Blood Sampling: A thin long needle is inserted through the mother's abdomen to collect the blood from fetus to test for the infection.

Congenital Toxoplasmosis Treatment

Typically babies diagnosed with Congenital Toxoplasmosis are given a combination treatment of pyrimethamine, sulfadiazine and leucovorin for one year and in case of fetal infection, pyrimethamine and sulfadiazine is usually prescribed by the doctor. The duration of the treatment and the combination of the medication will be decided by the healthcare provider based on the baby's condition and what is best suited for each case.

Congenital Toxoplasmosis Life Expectancy

Life expectancy in case of congenital toxoplasmosis completely depends on the severity of the damage and the timing of the treatment. In cases where the treatment was done early on during pregnancy or shortly after the birth and the symptoms were mild the baby has a very good chance to make complete recovery. In cases of severe damage, the baby could suffer serious complications like neurological damage, hydrocephaly, complex eye disabilities or damage to even death in severe cases.