Congenital Toxoplasmosis: The State of the Art

Frontiers in Pediatrics

article

Lina Bollani¹  Cinzia Auriti²  Cristian Achille¹  Francesca Garofoli¹  Domenico Umberto De Rose²  Valeria Meroni³  Guglielmo Salvatori²  Chryssoula Tzialla¹ 

[1] Neonatal Intensive Care Unit, Fondazione IRCCS Policlinico San Matteo;Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus – Newborn – Infant, “Bambino Gesù” Children’s Hospital;Department of Molecular Medicine, University of Pavia

关键词: congenital infections;    Toxoplasma gondii;    chorioretinitis;    diagnosis;    follow-up;    pregnancy;    neonate;   

DOI  :  10.3389/fped.2022.894573

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Infection with the protozoan parasite Toxoplasma gondii occurs worldwide and usually causes no symptoms. However, a primary infection of pregnant women, may infect the fetus by transplacental transmission. The risk of mother-to-child transmission depends on week of pregnancy at the time of maternal infection: it is low in the first trimester, may reach 90% in the last days of pregnancy. Inversely, however, fetal disease is more severe when infection occurs early in pregnancy than later. Systematic serologic testing in pregnant women who have no antibodies at the beginning of pregnancy, can accurately reveal active maternal infection. Therefore, the risk of fetal infection should be assessed and preventive treatment with spiramycin must be introduced as soon as possible to reduce the risk of mother-to-child transmission, and the severity of fetal infection. When maternal infection is confirmed, prenatal diagnosis with Polymerase Chain Reaction (PCR) on amniotic fluid is recommended. If fetal infection is certain, the maternal treatment is changed to a combination of pyrimethamine-sulfonamide and folinic acid. Congenitally infected newborns are usually asymptomatic at birth, but at risk for tardive sequelae, such as blindness. When congenital infection is evident, disease include retinochoroiditis, cerebral calcifications, hydrocephalus, neurocognitive impairment. The diagnosis of congenital infection must be confirmed at birth and management, specific therapy, and follow-up with multidisciplinary counseling, must be guaranteed.

【 授权许可】

CC BY