Toxoplasmosis: Complications

In healthy adults, the infection usually progresses without symptoms. However, a first-time infection during pregnancy always results in severe damage (e.g., to the eyes or brain/chorioretinitis or hydrocephalus) in the unborn child, some of which may not become apparent for years.

The following are the most important diseases or complications that can be caused by toxoplasmosis:

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Hydrocephalus (hydrocephalus; abnormal enlargement of the fluid-filled fluid spaces (cerebral ventricles) of the brain).

Respiratory system (J00-J99)

  • Pneumonia (pneumonia)

Eyes and eye appendages (H00-H59).

  • Chorioretinitis – inflammation of the choroid (choroid) with retinal (retina) involvement.
  • Iritis – inflammation of the iris in the eye.
  • Cataract (cataract) – clouding of the lens of the eye.
  • Optic atrophy – reduction of vision due to degeneration of the optic nerve.
  • Posterior uveitis/inflammation of the posterior segments of the eye (as a result of ocular toxoplasmosis, OT) → T. gondii infection of the retina (retina) → irreversible visual impairmentNote: Approximately 4% of uveitis manifestations are due to T. gondii infection in Germany.

Certain conditions originating in the perinatal period (P00-P96).

  • Preterm birth
  • Congenital toxoplasmosis (congenital toxoplasmosis).

Skin and subcutaneous tissue (L00-L99)

  • Chronic spontaneous urticaria – persistent wheal formation or angioedema (acute onset, painless edema (swelling) of the subcutis (lower layer of the skin) or submucosa (layer of tissue between the mucosa and the muscle layer); or a combination of both) lasting longer than six weeks; cause is not always known

Cardiovascular system (I00-I99).

Infectious and parasitic diseases (A00-B99).

  • Gastroenteritis (gastroenteritis).
  • Cerebral toxoplasmosis in immunocompromised individuals (most common opportunistic infection in HIV-infected individuals).

Liver, gallbladder, and biliary tract-pancreas (pancreas) (K70-K77; K80-K87).

  • Hepatitis (inflammation of the liver)
  • Pancreatitis (inflammation of the pancreas)

Musculoskeletal system and connective tissue (M00-M99).

  • Myositis – inflammatory muscle disease.

Psyche – nervous system (F00-F99; G00-G99)

  • Encephalitis (inflammation of the brain) – can be reactivated at any time in immunosuppressed individuals.
  • Epilepsy
  • Mental retardation
  • Cerebral atrophy – decrease in the mass of the cerebrum.
  • Intracranial calcifications – calcifications in the brain.
  • Severe neurologic disease in HIV-positive patients.

Pregnancy, childbirth and puerperium (O00-O99).

  • Abortion (miscarriage)

Symptoms and abnormal clinical and laboratory findings, not elsewhere classified (R00-R99).

  • Splenomegaly (splenomegaly).

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

Further

  • Transplant recipients: recipients of solid organs or after hematologic stem cell transplantation may develop toxoplasmosis.

Prognostic factors

Unfavorable prognostic factors for the fetus are:

  • Maternal infection in the 1st trimester (third trimester of pregnancy).
  • High IgG titer, positive IgA findings.
  • Positive amniotic fluid PCR
  • Pathological sonographic findings (abnormal ultrasound findings).
  • Start of therapy > 8 weeks after infection date.
  • Low drug level