Toxoplasmosis

Diagnosis

A diagnosis of toxoplasmosis is primarily based on blood tests. Laboratory tests detect two types of antibodies:

• One antibody indicates a new and active infection with the parasite
• The other antibody shows if you had an infection at any time in the past

Depending on results, your healthcare provider may repeat the test after two weeks. Additional diagnostic tests may be needed based on symptoms, overall health, and other factors.

Eye symptoms
If you experience eye-related issues, an ophthalmologist may examine the eyes using special lenses or cameras to view tissues inside the eye.

Brain and nervous system symptoms
If brain inflammation is suspected, tests may include:

• Brain imaging with MRI or CT scans to detect irregular structures
• Cerebrospinal fluid (CSF) tests to identify toxoplasma in the fluid surrounding the brain and spinal cord
• Rarely, removal of brain tissue for testing

Pregnancy
Routine screening for toxoplasmosis in pregnancy is not standard in the United States. Diagnostic tests may be recommended if:

• Symptoms suggest an active infection
• Ultrasound of the baby shows irregular features linked to toxoplasmosis

Amniotic fluid testing may be done using a fine needle to assess infection in the womb if necessary.

Newborn
Blood tests may be ordered for suspected infection in newborns. Positive cases are monitored with:

• Brain imaging using ultrasound or CT scans
• Tests of cerebrospinal fluid
• Eye exams
• Hearing tests
• Electroencephalogram to assess brain activity

Treatment

Medication is used to treat active toxoplasmosis. The type, dosage, and duration depend on illness severity, immune system health, infection location, and pregnancy stage. Common treatments include:

• Pyrimethamine to fight the infection, often paired with leucovorin calcium to reduce effects on folic acid
• Sulfadiazine or other antibiotics such as clindamycin and azithromycin

Treatment for infants may last 1 to 2 years, with frequent follow-ups to monitor side effects, vision, and overall development.

Additional treatment for eye disease may include anti-inflammatory steroids called glucocorticosteroids to reduce inflammation and protect vision.