Evaluation and Treatment of Fetal Exposure to Toxoplasmosis

Abstract

Symptomatic congenital toxoplasmosis is a rare disease in the United States. However, prenatal screening is becoming increasingly available, resulting in identification of infants at risk of developing the disease. Infants who are born asymptomatic may still develop significant neurodevelopmental sequelae months or even years after birth if untreated. Congenital toxoplasmosis is a difficult infection to diagnose. Using one case as an example, this review attempts to highlight the importance of identifying at-risk infants and summarize the most current recommendations with regard to workup and treatment of affected infants. Initial evaluation of an infant at risk of congenital toxoplasmosis includes complete history and physical examination, lumbar puncture, head computed tomography, complete blood cell count with differential, detailed ophthalmologic examination, and Toxoplasma gondii polymerase chain reaction and serologic testing. Because of the complexity of the laboratory studies involved, expert interpretation is required. Although there is still much to learn about the best approach to the identification and treatment of affected infants, we know that early treatment leads to the best neurodevelopmental outcomes.