Maternal and Congenital Toxoplasmosis: Diagnosis and Treatment Recommendations of a French Multidisciplinary Working Group

François Peyron (1) , Coralie L'Ollivier (2) , Laurent Mandelbrot (3) , Martine Wallon (1) , Renaud Piarroux (4) , Francois Kieffer (5) , Eve Hadjadj (6) , Luc Paris (7) , Patricia Garcia -Meric (8)

1 Département de parasitologie et de mycologie [CHU - HCL Hôpital de la Croix-Rousse]
2 Département de Parasitologie [AP-HM Hôpital de la Timone]
3 DHU Risks in Pregnancy - Département d'obstétrique et de gynécologie [AP-HP Hôpital Louis-Mourier]
4 iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique
5 Service de néonatologie [CHU Trousseau]
6 Consultations Ophtalmologique [AP-HM Hôpital Sainte-Marguerite]
7 Service de Parasitologie - Mycologie [CHU Pitié-Salpétrière]
8 Département de Médecine Néonatale [AP-HM Hôpital de la Conception]

Women infected with toxoplasmosis during pregnancy do not present symptoms in most cases, but the consequences of the congenital infection may be severe for the unborn child. Fetal damage can range from asymptomatic to severe neurological alterations to retinal lesions prone to potential flare up and relapses lifelong. Despite the possible severity of outcome, congenital toxoplasmosis (CT) is a neglected disease. There is no consensus regarding screening during pregnancy, prenatal/postnatal treatment or short or medium term follow-up. Since 1992, France has offered systematic serological testing to non-immune pregnant women, monthly until delivery. Any maternal infection is thus detected; moreover, diagnosis of congenital infection can be made at birth and follow-up can be provided. "Guidelines" drawn up by a multidisciplinary group are presented here, concerning treatment, before and after birth. The recommendations are based on the regular analysis of the literature and the results of the working group. The evaluation of the recommendations takes into account the robustness of the recommendation and the quality of the evidence.

Keywords: treatment of fetal infections; follow-up of congenital infection; congenital toxoplasmosis; guidelines

Domains: Quantitative Methods [q-bio.QM]

François Peyron, Coralie L'Ollivier, Laurent Mandelbrot, Martine Wallon, Renaud Piarroux, et al.. Maternal and Congenital Toxoplasmosis: Diagnosis and Treatment Recommendations of a French Multidisciplinary Working Group. Pathogens, 2019, 8 (1), pp.24. ⟨10.3390/pathogens8010024⟩. ⟨inserm-02070252⟩