title: Congenital toxoplasmosis transmitted from an immunologically competent mother infected before conception.
abstract: Congenital transmission of Toxoplasma gondii from a mother who was apparently immunologically competent and who had toxoplasmic lymphadenitis 2 months before conception is described. Since no T. gondii-specific serological data were available for this mother from the time her lymph node biopsy specimen was obtained, the specimen was studied by polymerase chain reaction (PCR) to determine whether the T. gondii B1 gene was present. The predictive diagnostic value of histologic findings previously considered to be classic signs of T. gondii lymphadenitis also was studied. This was done by correlation of serological tests diagnostic of acute acquired T. gondii infection and presence of characteristic findings in biopsy specimens from persons without known immunocompromise. Both PCR and review of the characteristic features of her lymph node biopsy specimen confirmed the diagnosis of preconceptual infection in the mother. We also discuss two other cases in which apparently immunologically competent mothers with preconceptually acquired infection transmitted this parasite to their fetuses.
authors.affiliation: Michael Reese Hospital, University of Illinois, Rush Medical School, University of Chicago, Illinois Institute of Technology, Northwestern Children's Hospital, USA.
authors.forename: N
authors.initials: N
authors.lastname: Vogel
authors.forename: M
authors.initials: M
authors.lastname: Kirisits
authors.forename: E
authors.initials: E
authors.lastname: Michael
authors.forename: H
authors.initials: H
authors.lastname: Bach
authors.forename: M
authors.initials: M
authors.lastname: Hostetter
authors.forename: K
authors.initials: K
authors.lastname: Boyer
authors.forename: R
authors.initials: R
authors.lastname: Simpson
authors.forename: E
authors.initials: E
authors.lastname: Holfels
authors.forename: J
authors.initials: J
authors.lastname: Hopkins
authors.forename: D
authors.initials: D
authors.lastname: Mack
authors.forename: M B
authors.initials: MB
authors.lastname: Mets
authors.forename: C N
authors.initials: CN
authors.lastname: Swisher
authors.forename: D
authors.initials: D
authors.lastname: Patel
authors.forename: N
authors.initials: N
authors.lastname: Roizen
authors.forename: L
authors.initials: L
authors.lastname: Stein
authors.forename: M
authors.initials: M
authors.lastname: Stein
authors.forename: S
authors.initials: S
authors.lastname: Withers
authors.forename: E
authors.initials: E
authors.lastname: Mui
authors.forename: C
authors.initials: C
authors.lastname: Egwuagu
authors.forename: J
authors.initials: J
authors.lastname: Remington
authors.forename: R
authors.initials: R
authors.lastname: Dorfman
authors.forename: R
authors.initials: R
authors.lastname: McLeod
mesh_terms: D000818:Animals; D005260:Female; D005306:Fertilization; D006801:Humans; D007121:Immunocompetence; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases; D018445:Infectious Disease Transmission, Vertical; D008198:Lymph Nodes / Q000469:parasitology / Q000473:pathology; D008199:Lymphadenitis / Q000469:parasitology* / Q000473:pathology / Q000503:physiopathology; D051379:Mice; D009035:Mothers; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed; D014122:Toxoplasma / Q000235:genetics / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000469:parasitology / Q000473:pathology / Q000503:physiopathology / Q000635:transmission*