Review Question - QID 105444

The infant in the question stem most likely suffers from congenital toxoplasmosis as a result of maternal exposure to cat feces.

Primary exposure to Toxoplasma gondii in an otherwise healthy female is usually asymptomatic; however, mild symptoms can range from fatigue, malaise, and low-grade fevers to lymphadenopathy and myalgias. Most cases of congenital toxoplasmosis occur secondary to reactivation of latent Toxoplasma infection in immunocompromised mothers, such as those with HIV or AIDS.

Jones et al. discuss the three primary routes for T. gondii infection: (1) eating raw or inadequately cooked infected meat, especially pork, mutton, and wild game; (2) ingestion of oocysts from cat feces in litter or soil; or (3) placental transmission of the infection to an unborn fetus.

Montoya and Remington discuss the complications related to intrauterine Toxoplasmosis infection. In immunocompetent mothers, transmission to the fetus occurs almost solely in women who acquire their primary infection during gestation. Infected infants often present with visual and hearing loss, mental and psychomotor retardation, seizures, hematological abnormalities, hepatosplenomegaly, or death. They report that treatment of the infection in the fetus and infant in the first year of life leads to improved clinical outcomes.

Figure A is a radiograph demonstrating intracranial calcifications and hydrocephalus secondary to congenital Toxoplasmosis.
Figure B is a computed tomagraphy scan demonstrating similar findings.

Incorrect Responses:
Answer 1: Consumption of goat cheese during pregnancy has been associated with Listeriosis.
Answer 2: Excessive alcohol consumption during pregnancy can lead to fetal alcohol syndrome.
Answer 3: Overconsumption of predatory fish (higher in the food chain) can lead to mercury and other heavy metal poisoning.
Answer 4: Contact with avian feces can lead to Chlamydia psittaci infection.