Toxoplasmosis Forest

Question 1

How do you get toxoplasma gondii?

Answer 1

Ingest toxoplasma tissue cysts in undercooked/cured meat or from infectious oocysts from cats/soil

Question 2

Incidence of toxoplasmosis in pregnancy in UK?

Answer 2

0.2% / 2 in 1000

Question 3

When is fetal transmission highest?
When is fetal severity worst?

Answer 3

Toxo transmission rate increases with gestational age at seroconversion - 60% at 36 weeks
BUT severity is greatest when infection occurs in 1st trimester
(Same as CMV)

Question 4

Sequelae of congenital infx with toxo?

Answer 4

Mainly CNS and eyes. Blindness, microcephaly, ventriculomegaly, learning difficulties, convulsions, hepatosplenomeg, rash, jaundice
BBCC - blind brain convulsions calcifications

Question 5

How to test for maternal toxo infx?

Answer 5

IgG and IgM and can utilise booking serum (to see if negative then)

Question 6

If confirmed primary toxo infx, what should you do?

Answer 6

Refer to FM
Amnio from 16w

Question 7

How to treat toxo in pregnancy?

Answer 7

Spiramycin reduces risk of fetal infection by 60-70% so give ASAP
BUT doesn’t reduce severity of disease
In confirmed infx - can give pyrimethamine/salfadiazine

Question 8

Ultrasound features of toxo?

Answer 8

ventriculomegaly, hydrocephalus, microcephaly, intracerebral calcification, cataract formation, ascites