Grand Rounds

Is it Congenital Toxoplasmosis?


Lavina Desai*, Ira Shah**
* Seth G S Medical College, Mumbai, India, and **Pediatric Infectious Diseases, Levioza Health Care, Mumbai, India.

Address for Correspondence: Lavina Desai, Seth G S Medical College, India. Email: lavinadesai16@gmail.com


Clinical Problem:
A 15 day old boy was referred in April 2016 to rule out congenital toxoplasmosis. His mother’s obstetric history was complicated with loss of the first pregnancy at 8 months due to still birth, loss of the second pregnancy at 5 months due to spontaneous abortion, loss of the third and the fourth pregnancy at 5 and 6 weeks respectively. He was born premature at 35 weeks of gestation due to preeclampsia by lower segment cesarean section and spent 2 days in the neonatal intensive care unit (NICU). His birth weight was 2 kg and he was exclusively breast fed thereafter. On examination he was jaundiced without any organomegaly. His mother’s serological TORCH titres are shown in the table 1. The child’s toxoplasmosis IgG was 40.4 IU/ml and IgM was 0.018 IU/ml (negative). As maternal titres were positive in the first trimester and the newborn developed jaundice on day 15, his PCR for T. gondii, ultrasound of brain and eye examination to check for any manifestations of infection along with mother’s toxoplasma PCR and eye examination was advised.

Table: Mother’s serological titres

How to diagnose congenital toxoplasmosis?


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