Most pregnant women in the United States aren't routinely screened for toxoplasmosis, and most states don't screen infants for the infection. Without specific screening, toxoplasmosis is often difficult to diagnose because signs and symptoms, when they occur, are similar to those of more common illnesses such as the flu and mononucleosis.
Testing in pregnancy
If your doctor suspects you have the infection, you may have several blood tests that check for antibodies to the parasite. Antibodies are proteins produced by your immune system in response to the presence of foreign substances, including viruses, bacteria, fungi, parasites, drugs and toxins. Because these antibody tests can be difficult to interpret, the Centers for Disease Control and Prevention (CDC) recommends that all positive results be confirmed by a laboratory that specializes in diagnosing toxoplasmosis.
What test results mean
Sometimes you may be tested early in the course of the disease before your body has a chance to produce antibodies. In that case, you may have a negative result, even though you're infected. To be certain, your doctor may recommend retesting several weeks later. In most cases, though, a negative toxoplasmosis test result means you've never been infected and therefore aren't immune to the disease. If you're at high risk, you can take certain precautions so that you don't become infected in the future.
A positive result could mean that you have an active infection, or it could mean that you were infected at some point in your life and you're now immune to the disease. Additional tests can pinpoint when the infection occurred, based on the types of antibodies in your blood. This is especially important if you're pregnant or you have HIV/AIDS.
Testing your baby
If you're pregnant and have a current toxoplasmosis infection, the next step is to determine whether your baby also is infected. Tests your doctor may recommend include:
- Amniocentesis. In this procedure, which may be done safely after 15 weeks of pregnancy, your doctor uses a fine needle to remove a small amount of fluid from the fluid-filled sac that surrounds the fetus (amniotic sac). Tests are then performed on the fluid to check for evidence of toxoplasmosis. The test carries a slight risk of miscarriage. You may also experience minor complications, such as cramping, leaking fluid or irritation where the needle was inserted.
- Ultrasound scan. This test uses sound waves to produce images of your baby in the womb. A detailed ultrasound can't diagnose toxoplasmosis, although it can show whether your baby has certain signs, such as fluid buildup in the brain (hydrocephalus). But because most infants don't show signs of toxoplasmosis at birth, a negative ultrasound doesn't rule out the possibility of infection. For that reason, your newborn will need a thorough examination after birth and follow-up blood tests during the first year of life.
Testing in severe cases
If you've developed a life-threatening illness such as encephalitis, you may need one or more imaging tests to check for lesions or cysts in your brain. These include:
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- Magnetic resonance imaging (MRI). This test uses a magnetic field and radio (electromagnetic) waves to create cross-sectional images of your head and brain. During the procedure, you lie inside a large, doughnut-shaped machine that contains a magnet surrounded by coils that send and receive radio waves. In response to these radio waves, your body produces faint signals that are picked up by the coils and processed into images by a computer. MRI is noninvasive and poses no risks to your health.
- Brain biopsy. In rare cases, especially if you don't respond to treatment, a neurosurgeon may take a small sample of tissue from your brain. The sample is then analyzed in a laboratory to check for toxoplasmosis cysts.
- Toxoplasmosis frequently asked questions (FAQs). Centers for Disease Control and Prevention. http://www.cdc.gov/parasites/toxoplasmosis/gen_info/faqs.html. Accessed May 24, 2011.
- Martin-Rabada P, et al. Blood and tissue protozoa. In: Cohen J, et al. Infectious Diseases. 3rd ed. Edinburgh, U.K.: Mosby Elsevier; 2010:1892.
- Kasper LH. Toxoplasma infections. In: Fauci AS, et al. Harrison's Online. 17th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aid=2896423. Accessed May 24, 2011.
- McLeod R, et al. Toxoplasmosis (toxoplasma gondii). In: Kliegman RM, et al. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-1-4160-2450-7&eid=4-u1.0-B978-1-4160-2450-7..50289-9. Accessed May 24, 2011.
- Pregnancy complications: Toxoplasmosis. March of Dimes. http://www.marchofdimes.com/Pregnancy/complications_toxoplasmosis.html. Accessed May 24, 2011.
- Centers for Disease Control and Prevention, et al. Preventing congenital toxoplasmosis. MMWR. 2000;49:57. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4902a5.htm. Accessed May 24, 2011.
- You can prevent toxo. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/resources/brochures/toxo.htm. Accessed May 24, 2011.
- Montoya JG, et al. Diagnosis and management of toxoplasmosis. Clinics in Perinatology. 2005;32:705.
- FDA clears first test for recent infection with toxoplasmosis parasite. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm255922.htm. Accessed May 23, 2011.