Toxoplasma gondii (Toxoplasmosis)

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Toxoplasma gondii (Toxoplasmosis)

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USMLE® Step 1 style questions USMLE

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A 35-year-old primigravid woman has a stillbirth at 21-weeks of gestation. The patient has been consistent with her prenatal care and taking daily prenatal vitamins. She returned from a trip to Nigeria 6 months ago. Past medical history is notable for type I diabetes mellitus. She developed a fever, swollen lymph nodes, and muscle aches during the pregnancy that lasted for a week. A fetal autopsy is notable for scattered intracranial calcifications, hydrocephalus, macrocephaly, and hepatosplenomegaly. Which of the following maternal exposures most likely resulted in this fetus’s condition?

Key Takeaways

Toxoplasma gondii is an obligate intracellular, parasitic protozoan that causes the disease toxoplasmosis. It is found worldwide and is capable of infecting virtually all warm-blooded animals, but felids such as domestic cats are the only known definitive hosts in which the parasite can undergo sexual reproduction. Cleaning cat litter boxes is a potential route of infection.

Transmission is by ingesting cysts in undercooked meat. If transmission occurs in a pregnant woman, the fetus can acquire congenital toxoplasmosis, whose features consist of the triad of chorioretinitis, hydrocephalus, and intracranial calcifications. Most healthy people recover from toxoplasmosis without treatment. However, ill individuals can be treated with druglike pyrimethamine, sulfadiazine, and folinic acid.