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Toxoplasmosis 

Toxoplasmosis
Chapter:
Toxoplasmosis
DOI:
10.1093/med/9780198729228.003.0120
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date: 26 June 2019

Toxoplasma gondii is an obligate intracellular protozoan parasite. The incidence of congenital toxoplasmosis in Northern Europe and the United States is thought to be ≤1 per 10–100 000 births. Congenital infection is associated with maternal primary infection in pregnancy. About one-third of infected women produce an infected fetus; first-trimester infection tends to produce more severe disease. By adolescence, 10–30% of infected infants will have developed chorioretinitis. Infection in humans results from ingestion of inadequately cooked meat or from contact with infected cat faeces. Most symptomatic infection in early childhood has been thought to result from congenital infection. Transmission occurs at any stage in pregnancy, but post-natal infection can also occur. The incubation period is usually about 7 days but may be between 4 and 21 days. Acquired toxoplasmosis may be asymptomatic or result in a mild infection with low-grade fever, headache, myalgia, sore throat, and lymphadenopathy. Congenital toxoplasmosis is characterized by the classic triad of chorioretinitis, hydrocephalus, and intracranial calcification. Laboratory-confirmed diagnosis is complex, and advice should be obtained from an accredited Toxoplasmosis Reference Laboratory. No treatment is usually required in healthy children with acute toxoplasmosis, although lymphadenopathy and other symptoms may persist for up to a year. The outcome for children with congenital infection depends on the severity of in utero cerebral damage, along with prompt diagnosis and treatment. The mainstay of prevention lies in the promotion of excellent hygiene, especially in pregnant women.

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