Neonatology pp 898-904 | Cite as

Toxoplasmosis in the Fetus and Newborn

  • Wilma Buffolano


In the developed world, human toxoplasmosis is considered a benign self-limiting disease mostly detectable by specific antibody Toxoplasma gondii-immunoglobulin (Tg-Ig) testing. Patent and sometimes devastating disease may be appreciated in immune-compromised hosts and congenitally infected infants [1]. Congenital toxoplasmosis (CT) occurs almost exclusively when primary maternal infection occurs during gestation. As more than half of mothers giving birth to infected offspring could not recall an infection-related illness and no test reliably marks off infection time, there is pressure for screening. Alternative strategies include prenatal surveillance in Tg-Ig negative pregnant women and prophylaxis of fetal infection/damage in seroconverters, and newborn Tg-IgM testing on filter paper blood spots and sequelae prophylaxis in the Tg-IgM positive infant. Monthly or quarterly re-testing of unprotected pregnant women has been widely practised in the EU since the ’70s, whereas newborn testing has been included in the New England Neonatal Screening Program (NENSP) since 1986, and feasibility confirmed across the globe.


Maternal Infection Tissue Cyst Congenital Toxoplasmosis Infected Infant Ocular Lesion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Montoya JG, Liesenfeld O (2004) Toxoplasmosis. Lancet 363: 1965–1976CrossRefGoogle Scholar
  2. 2.
    Gilbert R (2009) Treatment for congenital toxoplasmosis: finding out what works. Mem Inst Oswaldo Cruz 104: 305–311PubMedCrossRefGoogle Scholar
  3. 3.
    Vaillant V, de Valk H, Baron E et al (2005) Foodborne infections in France. Foodborne Pathog Dis 2: 221–232PubMedCrossRefGoogle Scholar
  4. 4.
    Bosch-Driessen LEH, Berendschot TTJM, Ongkosuwito JV, Rothova A (2002) Ocular toxoplasmosis. Clinical features and prognosis of 154 patients. Ophthalm 109: 869–878CrossRefGoogle Scholar
  5. 5.
    Flegr J, Klose J, Novotná M et al (2009) Increased incidence of traffic accidents in Toxoplasma-infected military drivers and protective effect RhD molecule revealed by a large-scale prospective cohort study. BMC Infect Dis 26; 9: 72CrossRefGoogle Scholar
  6. 6.
    Zhu S (2009) Psychosis may be associated with toxoplasmosis. Med Hypotheses 73: 799–801PubMedCrossRefGoogle Scholar
  7. 7.
    Carme B, Demar M, Ajzenberg D, Dardé ML (2009) Severe acquired toxoplasmosis caused by wild cycle of Toxoplasma gondii, French Guiana. Emerg Infect Dis 15: 656–658Google Scholar
  8. 8.
    Saeij JPJ, Boyle JP, Coller S et al (2006) Polymorphic secreted kinases are key virulence factors in toxoplasmosis. Science 314: 1780–1783PubMedCrossRefGoogle Scholar
  9. 9.
    Jamieson SE, de Roubaix LA, Kuan Tan H et al (2008) COL2A1 and ABCA4 are epigenetically modified and associated with congenital toxoplasmosis. PLoS One 3: e2285Google Scholar
  10. 10.
    Kortbeek LM, Hofhuis A, Nijhuis CDM, Havelaar AH (2009) Congenital toxoplasmosis and DALYs in the Netherlands. Mem Inst Oswaldo Cruz 104: 370–373PubMedCrossRefGoogle Scholar
  11. 11.
    Elbez-Rubinstein A, Ajzenberg D, Dardé ML et al (2009) Congenital toxoplasmosis and reinfection during pregnancy: case report, strain characterization, experimental model of reinfection, and review. J Infect Dis 199: 280–285PubMedCrossRefGoogle Scholar
  12. 12.
    Silveira C, Ferreira R, Muccioli C et al (2003) Toxoplasmosis transmitted to a newborn from the mother infected 20 years earlier. Am J Ophthalmol 136: 370–371PubMedCrossRefGoogle Scholar
  13. 13.
    Systematic Review on Congenital Toxoplasmosis Study Group (SYROCOT), Thiébaut R, Leproust S et al (2007) Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet 369: 115–122Google Scholar
  14. 14.
    McLeod R, Kieffer F, Sautter M et al (2009) Why prevent, diagnose and treat congenital toxoplasmosis? Mem Inst Oswaldo Cruz 104: 320–344PubMedCrossRefGoogle Scholar
  15. 15.
    Roberts A, Hedman K, Luyasu V et al (2001) Multicenter evaluation of strategies for serodiagnosis of primary infection with Toxoplasma gondii. Eur J Clin Microbiol Infect Dis 20: 467–474PubMedCrossRefGoogle Scholar
  16. 16.
    Gilbert RE, Thalib L, Tan HK et al (2007) Screening for congenital toxoplasmosis: accuracy of immunoglobulin M and immunoglobulin A tests after birth. J Med Screen 14: 8–13PubMedCrossRefGoogle Scholar
  17. 17.
    Bessières MH, Berrebi A, Cassaing S et al (2009) Diagnosis of congenital toxoplasmosis: prenatal and neonatal evaluation of methods used in Toulouse University Hospital and incidence of congenital toxoplasmosis. Mem Inst Oswaldo Cruz104: 389–392Google Scholar
  18. 18.
    Rilling V, Dietz K, Krczal D et al (2003) Evaluation of a commercial IgG/IgM Western blot assay for early postnatal diagnosis of congenital toxoplasmosis. Eur J Clin Microbiol Infect Dis 22: 174–180PubMedGoogle Scholar
  19. 19.
    Kaiser K, Van Loon AM, Pelloux H et al (2007) Multicenter proficiency study for detection of Toxoplasma gondii in amniotic fluid by nucleic acid amplification methods. Clin Chim Acta 375: 99–103PubMedCrossRefGoogle Scholar
  20. 20.
    Blankenberg FG, Nyu-Nyu Loh, Bracci P et al (2000) Sonography, CT, and MR imaging: a prospective comparison of neonates with suspected intracranial ischemia and hemorrhage. AJNR 21: 213–218PubMedGoogle Scholar
  21. 21.
    Hintz SR, Slovis T, Bulas D et al (2007). Interobserver reliability and accuracy of cranial ultrasound scanning interpretation in premature infants. J Pediatr 150: 592–596PubMedCrossRefGoogle Scholar
  22. 22.
    Knoblauch H, Tennstedt C, Brueck W et al (2003) Two brothers with findings resembling congenital intrauterine infection-like syndrome (pseudo-TORCH syndrome). Am J Med Genet 120A: 261–265CrossRefGoogle Scholar
  23. 23.
    McLeod R, Boyer K, Karrison T et al (2006) Outcome of treatment for congenital toxoplasmosis, 1981-2004: the National Collaborative Chicago-Based, Congenital Toxoplasmosis Study. Clin Infect Dis 42: 1383–1394Google Scholar
  24. 24.
    Phan L, Kasza K, Jalbrzikowski J et al (2008) Longitudinal study of new eye lesions in children with toxoplasmosis who were not treated during the first year of life. Am J Ophthalmol 146: 375–384PubMedCrossRefGoogle Scholar
  25. 25.
    Phan L, Kasza K, Jalbrzikowski J et al (2008) Longitudinal study of new eye lesions in treated congenital toxoplasmosis. Ophthalmol 115: 553–559CrossRefGoogle Scholar
  26. 26.
    Freeman K, Salt A, Prusa A et al (2005) Association between congenital toxoplasmosis and parent-reported developmental outcomes, concerns, and impairments, in 3 year old children. BMC Pediatr 5: 23PubMedCrossRefGoogle Scholar
  27. 27.
    Freeman K, Tan HK, Prusa A et al (2008) Predictors of retinochoroiditis in children with congenital toxoplasmosis: European, prospective cohort study. Pediatrics 121: e1215–e1222PubMedCrossRefGoogle Scholar
  28. 28.
    Gilbert RE, Freeman K, Lago EG et al (2008) Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe. PLoS Negl Trop Dis 2: e277Google Scholar
  29. 29.
    Stramba-Badiale M, Nador F, Porta N et al (1997) QT interval prolongation and risk of life-threatening arrhythmias during toxoplasmosis prophylaxis with spiramycin in neonates. Am Heart J 133: 108–111PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Wilma Buffolano
    • 1
  1. 1.Department of Paediatrics, Regional Register for Perinatal Infection and Special Unit for Perinatal InfectionFederico II University of NaplesNaplesItaly

Personalised recommendations