Table 3

Evidence of congenital Toxoplasma gondii infection versus end-organ disease

Evidence of congenital infectionEvidence of end-organ disease
Antenatal
  • Positive T. gondii NAAT on amniotic fluid.

  • Clinical features consistent with congenital toxoplasmosis on neonatal examination (table 2).

  • Typical abnormal findings on:

    • Neuroimaging.

    • Ophthalmology review.

    • Audiology review.

These findings may indicate subclinical end-organ damage.
  • Positive T. gondii NAAT on infant CSF.

Postnatal
  • Positive infant T. gondii-specific IgM and/or IgA beyond 2–3 weeks.

  • Significantly raised levels of T. gondii-specific IgM or IgG (≥4× titre) in the infant compared with the mother.

  • Increasing infant serial T. gondii-specific IgG titres or persistence beyond 12 months.

  • Positive T. gondii NAAT on infant specimens (including blood and CSF).

  • CSF, cerebrospinal fluid; Ig, immunoglobulin;NAAT, nucleic acid amplification test; T.gondii, Toxplasma gondii.