Toxoplasmosis in pregnancy

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Management

IgG IgM Interpretation Management
no prior infection; at risk counsel on prevention of primary infection (handwashing after litter, cook meat well, no raw eggs or unpasteurized dairy
+ acute primary infection or false positive repeat serology in 2 to 3 weeks; if unchanged, then was false positive
+ prior infection no risk of transmission except rare cases of immunocompromise
+ + recent or prior infection do avidity testing: if high avidity, infection was >4 months ago so unlikely to be acute; if low avidity, uncertain

Acute Infection

  • If acute infection, such as IgM + / IgG – that converts to IgG +, or IgM + / low IgG avidity with compatible clinical picture
  • Choice of antiparasitic

References

  1. ^  K. Boyer, D. Hill, E. Mui, K. Wroblewski, T. Karrison, J. P. Dubey, M. Sautter, A. G. Noble, S. Withers, C. Swisher, P. Heydemann, T. Hosten, J. Babiarz, D. Lee, P. Meier, R. McLeod. Unrecognized Ingestion of Toxoplasma gondii Oocysts Leads to Congenital Toxoplasmosis and Causes Epidemics in North America. Clinical Infectious Diseases. 2011;53(11):1081-1089. doi:10.1093/cid/cir667.