Toxoplasmosis is usually asymptomatic or a mild non-specific illness but primary infection during pregnancy can cause serious fatal, yet treatable, effects.
- no clearly defined group of women at increased risk
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- ∼ 75% of women remain susceptible
- False positive IgM not uncommon
- low levels IgM may persists months/years after primary infection
- toxoplasma remains latent for life (as with CMV) but clinical reactivation confined to severely immunosuppressed
- infants of mothers who were seropositive before conception are not at risk
Considerations of acute toxoplasmosis
- confirmed case / cannot be excluded ⇒ antibiotic treatment, especially during the first trimester, appears to reduce the risk of foetal infection and sequelae
- first-trimester likelihood of foetal infection is relatively low (∼ 15%) but foetal damage is severe
- later in pregnancy, though foetal infection is more likely, damage is less likely and, if it occurs, also less severe
