pediatrics
Congenital Toxoplasmosis
Key Points
Congenital toxoplasmosis is usually due to a primary maternal infection acquired during pregnancy; reactivation of prior infection is of low risk except in immunocompromised women. Many organs may be affected, including heart, liver, lungs, and central nervous system; the classic triad of findings consists of chorioretinitis, hydrocephalus, and intracranial calcifications. Some children have a fulminant course with early death, whereas others have long-term neurologic and ophthalmologic sequelae (which may not develop for several years or even decades). Do polymerase chain reaction (PCR) analysis of amniotic fluid (for fetal infection) or of body fluids (including cerebrospinal fluid) and tissues for neonatal infection; serologic testing may also be used. Do MRI or CT of the brain. Pyrimethamine,sulfadiazine, andleucovorinmay help. Pregnant women should cook meat thoroughly before consumption and should avoid contact with cat litter boxes and other areas contaminated with cat feces. 