Cats are the definitive host of the protozoan oocysts.
Maternal infection is often asymptomatic, but can have fever, lymphadenopathy, myalgias, and/or a diffuse, nonpruritic, maculopapular rash that resolves spontaneously.
Although maternal infection is mild, transplacental (vertical) transmission can result in devastating fetal infection.
T gondii preferentially destroys fetal neural tissue, which results in ultrasound findings
| Maternal risk factors | • Raw or undercooked meat • Unwashed produce (ie, contaminated soil) • Handling of cat feces | | --- | --- | | Clinical features | • Classic triad: ◦ Chorioretinitis ◦ Diffuse parenchymal intracranial calcifications especially the basal ganglia ◦ Hydrocephalus (bilateral ventriculomegaly) • Microcephaly (brain atrophy) or macrocephaly (severe hydrocephalus) • Seizures • Nonspecific findings: jaundice, hepatosplenomegaly, rash, growth restriction | | Diagnosis | • Toxoplasma serology or PCR | | Treatment | • Prenatal antitoxoplasmal therapy (eg, pyrimethamine, sulfadiazine, folinic acid) may decrease the risk of neurologic sequelae such as chorioretinitis, seizures, and intellectual disability. |
Patients should undergo amniocentesis for T gondii PCR testing of amniotic fluid to confirm the diagnosis.