Prenatal and Early Postnatal Diagnosis of Congenital Toxoplasmosis: Retrospective Study
Liliana Sá*, Ana Maria Ferreira, Teresa Pinheiro and Teresa Caldeira
Centro Hospitalar de Entre o Douro e Vouga (CHEDV), Department of Paediatrics and Neonatology, Portugal
*Corresponding Author: Liliana Sá, Centro Hospitalar de Entre o Douro e Vouga (CHEDV), Department of Paediatrics and Neonatology, Portugal.
December 24, 2021; Published: January 31, 2022
Background: Congenital toxoplasmosis occurs when there is a maternal primary infection during pregnancy and transplacental transmission of the parasite occurs to the fetus. The incidence is about 1- 10/10.000 births. It is a preventable disease with possible severe consequences. In the postnatal period, diagnosis is established by the persistence of anti-Toxoplasma IgG by 12 months of age.
Methods: We performed a retrospective study of children with suspected congenital toxoplasmosis born in our hospital between 2008 and 2018. The aim was to define the clinical and serological characteristics of children with congenital toxoplasmosis to optimize diagnostic work-up and treatment.
Results: Of the 51 suspected cases only 7.8% proved to be infected. Seroconversion occurred mostly in the 1st trimester (49%). Amniocentesis was performed in 39.2% of women and all tested negative in the polymerase chain reaction for Toxoplasma gondii DNA detection in the amniotic fluid. 60.8% of women were treated with spiramycin. All children were asymptomatic at birth except for one that presented with chorioretinitis. 68.6% of infants started treatment immediately after birth (40% spiramycin, 57% pyrimethamine/sulfadiazine). Median treatment duration was 2.4 months and interruption was determined by a negative polymerase chain reaction for Toxoplasma gondii in peripheral blood. None tested positive for toxoplasma specific IgM nor polymerase chain reaction test. In two cases anti- Toxoplasma IgG tested positive after the first year of life and treatment was re-introduced. No significant impairments were detected.
Conclusions: Given the characteristics of this infection, to confirm or exclude congenital toxoplasmosis several serological and parasitological tests are required.
Keywords: Chorioretinitis; Congenital Infection; Congenital Toxoplasmosis; Thalamic Calcifications; TORCH
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