Abstract
The ability to diagnose congenital toxoplasmosis has been hampered by both the lack of a readily available means of isolating the causative organism Toxoplasma gondii and the apparent inability of many commercially available serological assays to detect Toxoplasma-specific immunoglobulin (Ig) M or IgA in congenitally infected infants because of inadequate sensitivity. This chapter concisely reviews the current state of the art of diagnosing congenital Toxoplasma infection and reviews present guidelines for making this diagnosis both pre- and postnatally.
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References
Remington JS, McLeod R, Thulliez, P, Desmonts G. Toxoplasmosis. In: Remington JS, Klein JO, eds. Infectious Diseases of the Fetus and Newborn Infant, 5th ed. Philadelphia: Saunders, 2001:205–346.
Smith J, McNeil G, Zhang Y, et al. Serological recognition of Toxoplasma gondii cyst antigens. In: Gross U, ed. Toxoplasma gondii. Berlin: Springer, 1996:67–75.
Mitchell C. Toxoplasmosis. In: Pizzo P, Wilfert C, eds. Pediatric AIDS, 2nd ed. Baltimore, MD: Williams and Wilkins, 1994:419–431.
Boyer K, Remington J, McLeod R. Toxoplasmosis. In: Feigin R, Cherry J, Demmler G, Kaplan S, eds. Textbook of Pediatric Infectious Diseases, 5th ed. Philadelphia: Saunders, 2004:2755–2770.
Gross U, Roggenkamp A, Janitschke K, et al. Improved sensitivity of the polymerase chain reaction for the detection of Toxoplasma gondii in biological and human clinical specimens. Eur J Clin Microbiol 1992;11:33–39.
Jones JL, Lopez A, Wilson M, Schulkin J, Gibbs R. Congenital toxoplasmosis: a review. Obstet Gynecol Survey 2001;56:296–305.
Remington JS, Gentry LO. Acquired toxoplasmosis: infection vs disease. Ann N Y Acad Sci 1970;174:1006–1017.
Siim JC. Clinical and diagnostic aspects of human acquired toxoplasmosis. Human Toxoplasmosis 1960;53–79.
Remington JS. Toxoplasmosis in the adult. Bull N Y Acad Med 1974;50:211–227.
Jones TC, Kean BH, Kimbal AC. Acquired toxoplasmosis. N Y State J Med 1969;69:2237–2242.
Wallon M, Dunn D, Slimani D, et al. Diagnosis of congenital toxoplasmosis at birth: what is the value of testing for IgM and IgA? Eur J Pediatr 1999;158:645–649.
Villena I, Aubert D, Brodard V, et al. Detection of specific immunoglobulin E during maternal, fetal and congenital toxoplasmosis. J Clin Microbiol 1999;37:3487–3490.
Dunn D, Wallon M, Peyron F, et al. Mother to child transmission of toxoplasmosis: risk estimates for clinical counseling. Lancet 1999;353:1899–1900.
Montoya JG, Remington JS. Toxoplasma gondii. In: Mandel GL, Bennett JE, Dolin R, eds. Mandel, Douglas, and Bennetts’ Principles and Practice of Infectious Diseases, 5th ed. Philadelphia: Churchill Livingstone, 2000:2858–2888.
Wilson M, McAuley JM. Toxoplasma. In: Murray PR, Baron ES, Pfaller MA, et al., eds. Manual of Clinical Microbiology, 7th Ed. Washington, DC: ASM Press, 1999:1374–1382.
Wilson M, Remington JS, Clavet C, et al. Evaluation of six commercial kits for detection of human immunoglobulin M antibodies to Toxoplasma gondii. J Clin Microbiol 1997;35:3112–3115.
Liesenfield O, Montoya JG, Tathineni NJ, et al. Confirmatory serologic testing for acute toxoplasmosis among women reported to have positive Toxoplasma immunoglobulin M antibody titers. Am J Obstet Gynecol 2001;184:140–145.
Romand S, Wallon M, Franck J, et al. Prenatal diagnosis using polymerase chain reaction on amniotic fluid for congenital toxoplasmosis. Obstet Gynecol 2001;97:296–300.
Robert-Gangneux F, Gavinet MF, Ancelle T, et al. Value of prenatal diagnosis and early postnatal diagnosis of congenital toxoplasmosis: retrospective study of 110. J Clin Microbiol 1999;37:2893–2898.
Foulon W, Pinon JM, Stray-Pedersen B, et al. Prenatal diagnosis of congenital toxoplasmosis: a multicenter evaluation of different diagnostic parameters. Am J Obstet Gynecol 1999;181:843–847.
Bader TJ, Macones GA, Asch DA. Prenatal screening for toxoplasmosis. Obstet Gynecol 1997;90:457–464.
American College of Obstetricians and Gynecologists. Perinatal Viral and Parasitic Infections. Washington, DC: American College of Obstetricians and Gynecologists, 2000. ACOG Practice Bulletin 20.
Robert-Gangneux F, Commerce V, Tourte-Schaefer C, et al. Performance of Western blot assay to compare mother and newborn anti-Toxoplasma antibodies for the early neonatal diagnosis of congenital toxoplasmosis. Eur J Clin Microbiol Infect Dis 1999;18:648–654.
Glasser L, Delta BG. Congenital toxoplasmosis with placental infection in monozygotic twins. Pediatrics 1965;35:276–283.
Desmonts G, Couvreur J. toxoplasmosis in pregnancy and its transmission to the fetus. Bull N Y Acad Med 1974;50:146–159.
Alford CA, Stagno S, Reynolds DW. Congenital toxoplasmosis: clinical laboratory and therapeutic considerations with special reference to sub clinical disease. Bull N Y Acad Med 1974;50:160–181.
Alford CA, Foft JW, Blankenship WJ, et al. Subclinical central nervous system disease of neonates: a prospective study of infants born with increased levels of IgM. J Pediatr 1969;75:1167–1178.
Eichenwald HF. A study of congenital toxoplasmosis with emphasis on clinical manifestations, sequelae and therapy. In: Siim JC, ed. Human Toxoplasmosis. Copenhagen: Munksgaard, 1960:41.
Wilson CB, Remington JS, Stagno S, et al. Development of adverse sequelae in children born with sub clinical congenital Toxoplasma infection. Pediatrics 1980;66:767–774.
Koppe JG, Loewer-Sieger DH, de Roever-Bonnet H. Results of 20-year follow-up of congenital toxoplasmosis. Lancet 1986;1:254–256.
Saxon SA, Knight W, Reynolds DW, et al. Intellectual deficits in children born with subclinical congenital toxoplasmosis: a preliminary report. J Pediatr 1973;8:2792.
Guerina NG, Hsu HW, Meissner HC, et al. Neonatal serologic screening and early treatment for congenital Toxoplasma gondii infection. The New England Regional Toxoplasma Working Group. N Engl J Med 1994;330:1858–1863.
Lebech M, Andersen O, Christensen NC, et al. Feasibility of neonatal screening for Toxoplasma infection in the absence of prenatal treatment. Danish Congenital Toxoplasmosis Study Group. Lancet 1999;353:1834–1837.
Foulon W, Naessens A, Ho-Yen D. Prevention of congenital toxoplasmosis. J Perinat Med 2000;28;337–345.
Feldman HA. Toxoplasmosis. Pediatrics 1958;22:559–574.
Mitchell CD, Erlich SS, Mastrucci MT, et al. Congenital toxoplasmosis occurring in infants perinatally infected with human immunodeficiency virus I. Pediatr Infect Dis J 1990;9:512–518.
Cohen-Addad NE, Joshi VV, Sharer LR, et al. Congenital toxoplasmosis: pathologic support for a chronology of events. J Perinatol 1988;8:328–331.
O’Donohoe JM, Brueton MJ, Holliman RE. Concurrent congenital human immunodeficiency virus infection and toxoplasmosis. Pediatr Infect Dis J 1991;10:627–628.
Miller MJ, Remington JS. Toxoplasmosis in infants and children with HIV infection or AIDS. In: Pizzo PA, Wilfert CM, eds. Pediatric AIDS: The Challenge of HIV Infection in Infants, Children and Adolescents. Baltimore, MD: Williams and Wilkins, 1990:299–307.
Roberts F, McLeod R, Boyer K. Toxoplasmosis. In: Katz S, Gershon A, Hotez P, eds. Krugman’s Infectious Diseases of Children, 10th ed. St. Louis, MO: Mosby, 1998:538–570.
Miller MJ, Seaman E, Remington JS. The clinical spectrum of congenital toxoplasmosis: problems in recognition. J Pediatr 1967;70:714–723.
Hendenstrom G, Huldt G, Langercrantz R. Toxoplasmosis in children. A study of 83 Swedish cases. Acta Pediatr 1961;50:304–312.
Couvreur J, Desmonts G, Girre JY. Congenital toxoplasmosis in twins. A series of 14 pairs of twins: absence of infection in one twin in two pairs. J Pediatr 1976;89:235–240.
Callahan WP, Russell WO, Smith MG. Human toxoplasmosis: a clinicopathologic study with presentation of five cases and review of the literature. Medicine 1946;25:343–397.
Pelloux H, Guy E, Angelici MC, et al. A second European collaborative study on polymerase chain reaction for Toxoplasma gondii, involving 15 teams. FEMS Microbiol Lett 1998;165:231–237.
Sabin AB, Feldman HA. Dyes as micro chemical indicators of a new immunity phenomenon affecting a protozoon parasite (Toxoplasma). Science 1948;108:660–663.
WHO Expert Committee on Biological Standardization. Twentieth report. WHO Tech Rep Ser 1968;384:1–100.
Balsari A, Poli G, Molina V, et al. ELISA for Toxoplasma antibody detection: a comparison with other serodiagnostic tests. J Clin Pathol 1980;33:640–643.
Gross U, Luder CG, Hendgen V, et al. Comparative immunoglobulin G antibody profiles between mother and child (CGMC test) for early diagnosis of congenital toxoplasmosis. J Clin Microbiol 2000;38:3619–3622.
Zufferey J, Hohlfeld P, Bille J, et al. Value of the comparative enzyme-linked immunofiltration assay for early neonatal diagnosis of congenital Toxoplasma infection. Pediatr Infect Dis J 1999;18:971–975.
McAuley J, Roizen N, Patel D, et al. Early and longitudinal evaluations of treated infants and children and untreated historical controls with congenital toxoplasmosis. Clin Infect Dis 1994;18:38–72.
Djurkovic-Djakovic O, Romand S, Nobre R, et al. Serologic rebounds after 1-year-long treatment for congenital toxoplasmosis. Pediatr Infect Dis J 2000;19:81–83.
Bessieres MH, Berrebi A, Rolland M, et al. Neonatal screening for congenital toxoplasmosis in a cohort of 165 women infected during pregnancy and influence of in utero treatment on the results of neonatal tests. Eur J Obstet Gynecol Reprod Biol 2001;94:37–45.
Villena I, Aubert D, Leroux B, et al. Pyrimethamine-sulfadoxine treatment of congenital toxoplasmosis; follow-up of 78 cases between 1980 and 1997. Reims Toxoplasmosis Group. Scan J Infect Dis 1998;30:295–300.
Remington JS. The present status of the IgM fluorescent antibody technique in the diagnosis of congenital toxoplasmosis. J Pediatr 1969;75:1116–1124.
Stagno S, Thiermann E. Valor de la immunofluorescencia indirecta en el diagnostico serologico de la toxoplasmosis aguda. Bol Chil Parasit 1970;25:915.
Aparicio Garrido A, Cour Boveda I. Aplicacion de la immunofluorescencia al estudio de las fracciones immunoglobulinicas en el diagnostico de la toxoplasmosis adquirida y congenita. Rev Clin Esp 1972;125:37–42.
Siegel JP, Remington JS. Comparison of methods for quantitating antigen-specific immunoglobulin m antibody with a reverse enzyme-linked immunosorbent assay. J Clin Microbiol 1983;19:63–70.
Naot Y, Remington JS. An enzyme-linked immunosorbent assay for detection of IgM antibodies of Toxoplasma gondii: use for diagnosis of acute acquired toxoplasmosis. J Infect Dis 1980;142:757–766.
Naot Y, Desmonts G, Remington JS. IgM enzyme-linked immunosorbent assay test for the diagnosis of congenital Toxoplasma infection. J Pediatr 1981;98:32–36.
Paul M, Petersen E, Pawlowski ZS, et al. Neonatal screening for congenital toxoplasmosis in the Poznan region of Poland by analysis of Toxoplasma gondii-specific IgM antibodies eluted from filter paper blood spots. Pediatr Infect Dis J 2000;19:30–36.
Araujo FG, Barnett EV, Gentry LO, et al. False-positive anti-Toxoplasma fluorescent-antibody tests in patients with antinuclear antibodies. Appl Microbiol 1971;22:270–275.
Hyde B, Barnett EV, Remington JS. Method for differentiation of nonspecific from specific Toxoplasma IgM fluorescent antibodies in patients with rheumatoid factor. Proc Soc Exp Biol Med 1975;148:1184–1189.
Pinon J, Puygauthier-Toubas D, Marx-Chemla C, et al. Detection of specific immunoglobulin E in patients with toxoplasmosis. J Clin Microbiol 1990;28:1739–1743.
Wallon M, Dunn D, Slimani D, et al. Diagnosis of congenital toxoplasmosis at birth: what is the value of testing for IgM and IgA? Eur J Pediatr 1999;158:645–649.
Naessens A, Jenum PA, Pollak A, et al. Diagnosis of congenital toxoplasmosis in the neonatal period: a multicenter evaluation. J Pediatr 1999;135:714–719.
Wallon M, Claudie C, Rubio S, et al. Value of cerebrospinal fluid cytochemical examination for the diagnosis of congenital toxoplasmosis at birth in France. Pediatr Infect Dis J 1998;17:705–710.
Hayes K, Billson FA, Jack I, et al. Cell culture isolation of Toxoplasma gondii from an infant with unusual ocular features. Med J Aust 1973;1:1297–1299.
Harvas JA, Fiol M, Caimari M, et al. Central nervous system congenital toxoplasmosis mimicking brain abscesses. Pediatr Infect Dis J 1987;6:491–492.
Coffey JD Jr. Congenital toxoplasmosis 38 years ago [letter to the editor]. Pediatr Infect Dis 1985;4:214.
Abbas AMA. Comparative study of methods used for the isolation of Toxoplasma gondii. Bull WHO 1967;36:344–346.
Grover CM, Thulliez P, Remington JS, et al. Rapid prenatal diagnosis of congenital Toxoplasma infection by using polymerase chain reaction in amniotic fluid. J Clin Microbiol 1990;28:2297–2301.
Hohlfeld P, Daffos F, Costa J, et al. Prenatal diagnosis of congenital toxoplasmosis with a polymerase chain reaction test on amniotic fluid. N Engl J Med 1994;331:695–699.
Van de Ven E, Melchers W, Galama J, et al. Identification of Toxoplasma gondii infections by B1 gene amplification. J Clin Microbiol 1991;19:2120–2124.
Dupouy-Camet J, Bougnoux ME, Lavreda de Souza S, et al. Comparative value of polymerase chain reaction and conventional biological tests for the prenatal diagnosis of congenital toxoplasmosis. Ann Biol Clin 1992;50:315–319.
Frisker-Hidalgo H, Pullout H, Racine C, et al. Detection of Toxoplasma gondii in 94 placentae from infected women by polymerase chain reaction, in vivo, and in vitro cultures. Placenta 1998;19:545–549.
Jenum PA, Holberg-Petersen M, Melby KK, et al. Diagnosis of congenital Toxoplasma gondii infection by polymerase chain reaction (PCR) on amniotic fluid samples. The Norwegian experience. APMIS 1998;106:680–686.
Bergstrom T, Ricksten A, Nenonen N, et al. Congenital Toxoplasma gondii infection diagnosed by PCR amplification of peripheral mononuclear blood cells from a child and mother. Scand J Infect Dis 1998;30:202–204.
Gratzl R, Hayde M, Kohlhauser C, et al. Follow-up of infants with congenital toxoplasmosis detected by polymerase chain reaction analysis of amniotic fluid. Eur J Clin Microbiol Infect Dis 1998;17:853–858.
Cazenovia J, Forester F, Besieges M, et al. Contribution of a new PCR assay to the prenatal diagnosis of congenital toxoplasmosis. Prenat Diagn 1992;12:119–127.
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Chaparro, A., Mitchell, C.D. (2006). Toxoplasma gondii . In: Hutto, C. (eds) Congenital and Perinatal Infections. Infectious Disease. Humana Press. https://doi.org/10.1385/1-59259-965-6:245
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DOI: https://doi.org/10.1385/1-59259-965-6:245
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