Pathogenesis of Infection and Preconception Management of T. gondii Infection.

Abstract

Toxoplasmosis is an infection caused by the single-celled parasite Toxoplasma gondii. According to serologic surveys from the Third National Health and Nutrition Survey in the United States, about 23% of adolescents and adults have serologic signs of T. gondii infection, of which 15% are women of childbearing age. These infections are usually asymptomatic or cause mild symptoms in the adult (such as fever, malaise, and lymphadenopathy), but infection in the pregnant woman can cause serious health problems in the fetus if the parasite is transmitted (congenital toxoplasmosis) and cause severe sequelae in the infant such as chorioretinits, mental retardation, blindness, sensorineural deafness, and epilepsy. There is no conclusive evidence that preconception testing and care reduces Toxoplasma gondii infection or improves treatment of infected women. On the other hand, if preconception counseling is performed, women who tested positive can be reassured that they are not at risk of infection during pregnancy and those who tested negative can receive advice on how to prevent infection. Women who become infected during pregnancy should be treated. Cost-effective educational and early detection programs for pregnant women should be implemented to reduce the financial and emotional impact of this disease.