Ultrasound features of fetal toxoplasmosis: A contemporary multicenter survey in 88 fetuses

Abstract

Objective: To describe the lesions detected by prenatal ultrasound examination in congenital toxoplasmosis (CT). Methods: We retrospectively analyzed all cases of fetal infection with Toxoplasma gondii with ultrasound anomalies described by fetal medicine experts in 2009 to 2019 in 30 French centers. Results: Eighty-eight cases of CT were included. Forty-five (51.1%) had one or more cerebral signs only, 35 (39.8%) had cerebral plus extracerebral signs and 8 (9.1%) had extracerebral signs only. The main cerebral signs were intracranial hyperechogenic nodular foci (n = 60) of which 20 were isolated, ventriculomegalies (n = 44) which generally increased during follow-up, and periventricular abscesses (n = 12). The main extracerebral signs were hepatomegaly and/or splenomegaly (n = 14), small for gestational age (n = 14), ascites (n = 14, including 2 with hydrops), and hyperechogenic bowel (n = 11). Maternal infection occurred mostly in the first or second trimester (81 cases), periconceptionally in one and in the third trimester in six cases. The first ultrasound signs were detected after a median of 7 weeks (range: 1.4; 24.0) following maternal toxoplasmosis seroconversion. Conclusion: While no sign was specific of CT, there were typical associations of cerebral signs with or without extracerebral signs. Detailed ultrasound examination could improve prognostic evaluation, as well as diagnosis of CT in settings lacking serological screening.

Congenital Toxoplasmosis: Findings in Fetal MRI

“…The ultrasound findings associated with fetal toxoplasmosis are ventricular dilation, brain calcifications, hepatomegaly, splenomegaly, ascites, pleural effusion, and pericardial effusion [16][17][18]. In the present case, severe hydrocephalus and polyhydramnios were evident at 31 weeks of gestation, which were not present in previous ultrasound examinations according to the report.…”

Congenital toxoplasmosis in humans: an update of worldwide rate of congenital infections

“…Ultrasound sonography can aid the determination of severity of lesions in the fetus (Codaccioni et al, 2020).…”

“…A recent study in France retrospectively evaluated 88 cases of congenital toxoplasmosis with ultrasound anomalies diagnosed by fetal medicine experts, 45 (51.1%) had one or more cerebral lesions, the most common lesion being intracranial hyperechogenic cerebral nodular foci (Codaccioni et al, 2020). In Table 2, initial data from screening studies are listed; at that time only a few follow-up studies on infected children were undertaken.…”

Seroprevalence of Toxoplasma gondii infection among women of childbearing age in an endemic region of Romania, 2016–2018

“…If T. gondii primary infection occurs during pregnancy, this parasite may cause congenital infection with devastating consequences to the infected child, including chorioretinitis, blindness, cerebral calcifications, hydrocephalus, microcephaly, or developmental delay. Due to the severe complications of congenital toxoplasmosis, the seroprevalence of T. gondii in women of childbearing age should be monitored [ 2 , 16 , 18 ].…”