The development of the Sabin–Pinkerton triad despite prenatal screening for congenital toxoplasmosis

The paper presents a case of a boy who developed the symptoms of congenital toxoplasmosis: hydrocephalus, retinitis, choroiditis and intracranial calcifications (the Sabin–Pinkerton triad). Despite prenatal screening in the first trimester of pregnancy (in accordance with the guidelines of the Ministry of Health), which indicated the diagnosis of asymptomatic primary Toxoplasma gondii infection in the pregnant mother, no antiparasitic therapy was used. The presented serological and imaging findings, as well as specialist consultations confirm the intensified effects of congenital infection in the child. Although the child was put on anti-toxoplasma therapy immediately after birth, he developed severe psychophysical development disorders. The paper discusses recommendations for maternal diagnosis and antiparasitic treatment that could have prevented the full-blown congenital toxoplasmosis in the described patient.

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Incidence of congenital toxoplasmosis in southern Brazil: a prospective study

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652003000300006 ◽

2003 ◽

Vol 45 (3) ◽

pp. 147-151 ◽

Cited By ~ 18

Author(s):

Liége Mozzatto ◽

Renato Soibelmann Procianoy

Keyword(s):

Toxoplasma Gondii ◽

Gestational Age ◽

Newborn Infants ◽

Congenital Toxoplasmosis ◽

Congenital Infection ◽

First Trimester ◽

Laboratory Diagnosis ◽

Anthropometric Measures ◽

Maternal Characteristics ◽

The Town

The study aimed to determine the incidence of congenital infection by Toxoplasma gondii and to describe neonatal and maternal characteristics regarding newborn infants treated at a teaching hospital in the town of Passo Fundo, State of Rio Grande do Sul, Brazil. Cord blood samples collected from 1,250 live newborns were analyzed. The laboratory diagnosis was established by the detection of Toxoplasma gondii IgM using an enzyme linked fluorescent assay. Gestational age, intrauterine growth, anthropometric measures, and prenatal characteristics were assessed. The incidence of congenital toxoplasmosis at birth was 8/10,000 (95%CI 0.2-44.5). Mean birthweight was 3,080 ± 215.56 grams and mean gestational age was 38.43 ± 1.88 weeks. With regard to prenatal care, 58% of the pregnant patients visited their doctors five times or more and 38.9% were serologically tested for toxoplasmosis in the first trimester of pregnancy. The incidence of congenital toxoplasmosis was similar to that found in most studies conducted in our country and abroad. Our study sample is representative of the town of Passo Fundo and therefore it is possible to consider the frequency observed as the prevalence of the disease in this town during the study period.

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Incidence of Toxoplasma gondii Infection in 35,940 Pregnant Women in Norway and Pregnancy Outcome for Infected Women

Journal of Clinical Microbiology ◽

10.1128/jcm.36.10.2900-2906.1998 ◽

1998 ◽

Vol 36 (10) ◽

pp. 2900-2906 ◽

Cited By ~ 104

Author(s):

Pål A. Jenum ◽

Babill Stray-Pedersen ◽

Kjetil K. Melby ◽

Georg Kapperud ◽

Andrew Whitelaw ◽

...

Keyword(s):

Toxoplasma Gondii ◽

Pregnant Women ◽

Screening Program ◽

Transmission Rate ◽

Congenital Infection ◽

First Trimester ◽

Immunoglobulin M ◽

Capital City ◽

Toxoplasma Gondii Infection

From 1992 to 1994 a screening program for detection of specific Toxoplasma gondii antibodies involving 35,940 pregnant women was conducted in Norway. For women with serological evidence of primary T. gondii infection, amniocentesis and antiparasitic treatment were offered. The amniotic fluid was examined for T. gondii by PCR and mouse inoculation to detect fetal infection. Infants of infected mothers had clinical and serological follow-up for at least 1 year to detect congenital infection. Of the women 10.9% were infected before the onset of pregnancy. Forty-seven women (0.17% among previously noninfected women) showed evidence of primary infection during pregnancy. The highest incidence was detected (i) among foreign women (0.60%), (ii) in the capital city of Oslo (0.46%), and (iii) in the first trimester (0.29%). Congenital infection was detected in 11 infants, giving a transmission rate of 23% overall, 13% in the first trimester, 29% in the second, and 50% in the third. During the 1-year follow-up period only one infant, born to an untreated mother, was found to be clinically affected (unilateral chorioretinitis and loss of vision). At the beginning of pregnancy 0.6% of the previously uninfected women were falsely identified as positive by the Platelia Toxo-IgM test, the percentage increasing to 1.3% at the end of pregnancy. Of the women infected prior to pregnancy 6.8% had persisting specific immunoglobulin M (IgM). A positive specific-IgM result had a low predictive value for identifying primaryT. gondii infection.

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False Positive Values of Biomarkers of Prenatal Screening on Chromosomopathy as Indicators of a Risky Pregnancy

Journal of Medical Biochemistry ◽

10.2478/v10011-011-0010-x ◽

2011 ◽

Vol 30 (2) ◽

pp. 126-130 ◽

Cited By ~ 1

Author(s):

Jasmina Durković ◽

Luka Anđelić ◽

Bojana Mandić ◽

Denis Lazar

Keyword(s):

Genetic Screening ◽

False Positive ◽

Prenatal Screening ◽

Protein A ◽

First Trimester ◽

Maternal Serum ◽

Fetal Hypoxia ◽

Beta Hcg ◽

First Trimester Of Pregnancy ◽

Fetal Karyotype

False Positive Values of Biomarkers of Prenatal Screening on Chromosomopathy as Indicators of a Risky PregnancyGenetic screening on chromosomopathy has been performed on 2000 pregnant women in their first trimester of pregnancy by determining Pregnancy associated plasma protein-A and free-beta HCG biomarkers in maternal serum. After obtaining a normal fetal karyotype, the pathological values of the biomarkers have been correlated with other pregnancy disorders, and the possible causes of the positive genetic screening have been tested. 340 false positive biomarkers (17%) have been detected. The increased free-beta HCG (48.24%) had a significant influence. A significant correlation (p > 0.01) between the increased free-beta HCG and bleeding during pregnancy has been established. Complications occurred in 78.52% pregnancies with pathological biomarkers, MISSed in 13.82%, miscarriages in 10.88%, induced pregnancy terminations caused by fetal anomalies in 8.82% and births with disturbed fetal vitality in 45%. The research results have shown a significant correlation (p > 0.01) between the increased value of the free-beta HCG biomarkers and fetal hypoxia. The false positive genetic screening, caused by the increased free-beta HCG, can indicate placental dysfunction and fetal vitality disruption.

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Biogenic Silver Nanoparticles Can Control Toxoplasma gondii Infection in Both Human Trophoblast Cells and Villous Explants

Frontiers in Microbiology ◽

10.3389/fmicb.2020.623947 ◽

2021 ◽

Vol 11 ◽

Author(s):

Idessania Nazareth Costa ◽

Mayara Ribeiro ◽

Priscila Silva Franco ◽

Rafaela José da Silva ◽

Thádia Evelyn de Araújo ◽

...

Keyword(s):

Silver Nanoparticles ◽

Toxoplasma Gondii ◽

Chorionic Villus ◽

Congenital Toxoplasmosis ◽

Trophoblast Cells ◽

Promising Alternative ◽

Human Trophoblast ◽

Biogenic Silver Nanoparticles ◽

Bewo Cells ◽

Toxoplasma Gondii Infection

The combination of sulfadiazine and pyrimethamine plus folinic acid is the conventional treatment for congenital toxoplasmosis. However, this classical treatment presents teratogenic effects and bone marrow suppression. In this sense, new therapeutic strategies are necessary to reduce these effects and improve the control of infection. In this context, biogenic silver nanoparticles (AgNp-Bio) appear as a promising alternative since they have antimicrobial, antiviral, and antiparasitic activity. The purpose of this study to investigate the action of AgNp-Bio in BeWo cells, HTR-8/SVneo cells and villous explants and its effects against Toxoplasma gondii infection. Both cells and villous explants were treated with different concentrations of AgNp-Bio or combination of sulfadiazine + pyrimethamine (SDZ + PYZ) in order to verify the viability. After, cells and villi were infected and treated with AgNp-Bio or SDZ + PYZ in different concentrations to ascertain the parasite proliferation and cytokine production profile. AgNp-Bio treatment did not reduce the cell viability and villous explants. Significant reduction was observed in parasite replication in both cells and villous explants treated with silver nanoparticles and classical treatment. The AgNp-Bio treatment increased of IL-4 and IL-10 by BeWo cells, while HTR8/SVneo cells produced macrophage migration inhibitory factor (MIF) and IL-4. In the presence of T. gondii, the treatment induced high levels of MIF production by BeWo cells and IL-6 by HTR8SV/neo. In villous explants, the AgNp-Bio treatment downregulated production of IL-4, IL-6, and IL-8 after infection. In conclusion, AgNp-Bio can decrease T. gondii infection in trophoblast cells and villous explants. Therefore, this treatment demonstrated the ability to reduce the T. gondii proliferation with induction of inflammatory mediators in the cells and independent of mediators in chorionic villus which we consider the use of AgNp-Bio promising in the treatment of toxoplasmosis in BeWo and HTR8/SVneo cell models and in chorionic villi.

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RHΔgra17Δnpt1 Strain of Toxoplasma gondii Elicits Protective Immunity Against Acute, Chronic and Congenital Toxoplasmosis in Mice

Microorganisms ◽

10.3390/microorganisms8030352 ◽

2020 ◽

Vol 8 (3) ◽

pp. 352 ◽

Cited By ~ 3

Author(s):

Qin-Li Liang ◽

Li-Xiu Sun ◽

Hany M. Elsheikha ◽

Xue-Zhen Cao ◽

Lan-Bi Nie ◽

...

Keyword(s):

Toxoplasma Gondii ◽

Cellular Response ◽

Protective Efficacy ◽

Interleukin 2 ◽

Congenital Toxoplasmosis ◽

Congenital Infection ◽

Dense Granule ◽

Lethal Challenge ◽

Double Deletion ◽

Brain Cysts

In the present study, a dense granule protein 17 (gra17) and novel putative transporter (npt1) double deletion mutant of Toxoplasma gondii RH strain was engineered. The protective efficacy of vaccination using RHΔgra17Δnpt1 tachyzoites against acute, chronic, and congenital toxoplasmosis was studied in a mouse model. Immunization using RHΔgra17Δnpt1 induced a strong humoral and cellular response, as indicated by the increased levels of anti-T. gondii specific IgG, interleukin 2 (IL-2), IL-10, IL-12, and interferon-gamma (IFN-γ). Vaccinated mice were protected against a lethal challenge dose (103 tachyzoites) of wild-type homologous (RH) strain and heterologous (PYS and TgC7) strains, as well as against 100 tissue cysts or oocysts of Pru strain. Vaccination also conferred protection against chronic infection with 10 tissue cysts or oocysts of Pru strain, where the numbers of brain cysts in the vaccinated mice were significantly reduced compared to those detected in the control (unvaccinated + infected) mice. In addition, vaccination protected against congenital infection with 10 T. gondii Pru oocysts (administered orally on day 5 of gestation) as shown by the increased litter size, survival rate and the bodyweight of pups born to vaccinated dams compared to those born to unvaccinated + infected dams. The brain cyst burden of vaccinated dams was significantly lower than that of unvaccinated dams infected with oocysts. Our data show that T. gondii RHΔgra17Δnpt1 mutant strain can protect mice against acute, chronic, and congenital toxoplasmosis by balancing inflammatory response with immunogenicity.

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Presence of Toxoplasma gondii tissue cysts in human semen

10.1101/2021.10.27.466215 ◽

2021 ◽

Author(s):

Wen Han Tong ◽

Jana Hlaváčová ◽

Samira Abdulai-Saiku ◽

Šárka Kaňková ◽

Jaroslav Flegr ◽

...

Keyword(s):

Toxoplasma Gondii ◽

Sexual Transmission ◽

Congenital Toxoplasmosis ◽

Protozoan Parasite ◽

Specific Gene ◽

Human Populations ◽

Human Semen ◽

Latently Infected ◽

Clinically Significant ◽

Toxoplasma Gondii Infection

Toxoplasma gondii is a widely prevalent protozoan parasite in human populations. This parasite is thought to be primarily transmitted through undercooked meat and contamination by cat feces. Here, we demonstrate that Toxoplasma gondii cysts can be found within human semen, thus suggesting a potential for sexual transmission. We visualized Toxoplasma gondii cysts in ejaculates of immune-competent and latently infected human volunteers. We confirmed the encystment by probing transcription of a bradyzoite-specific gene in these structures. These observations extend previous observations of the parasite in semen of several non-human host species, including rats, dogs, and sheep. Toxoplasma gondii infection is a clinically significant infection, in view of its high prevalence, its purported role in neuropsychiatric disorders such as schizophrenia, as well as in the more serious form of congenital toxoplasmosis. Our demonstration of intact Toxoplasma gondii cysts in the ejaculate supports the possibility of sexual transmission of the parasite and provides an impetus for further investigations.

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IgG and IgM titres Problems in Determining Diagnosis of Toxoplasmosis

Jurnal Ilmiah Kedokteran Wijaya Kusuma ◽

10.30742/jikw.v6i2.58 ◽

2017 ◽

Vol 6 (2) ◽

pp. 1

Author(s):

Soedarto Soedarto

Keyword(s):

Pregnant Woman ◽

Congenital Toxoplasmosis ◽

Congenital Infection ◽

Screening Tests ◽

Reference Laboratory ◽

Serological Tests ◽

Serological Screening ◽

New Methods ◽

Sample Test ◽

Toxoplasma Gondii Infection

To determine acute Toxoplasma gondii infection in pregnant women, is of interest worldwide due to the risk of congenital toxoplasmosis. Ability to diagnose recently acquired infection in the pregnant woman and congenital infection in the fetus and newborn was improved. Interpreting on maternal serological screening tests by new methods should not rely on a single sample test but need confirmatory testing through a nationally recognized reference laboratory if results of serological tests are positive.

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