Clinical approaches to diagnosing and managing congenital toxoplasmosis

Toxoplasma gondii is a globally prevalent intracellular parasite, which is the causative agent of congenital toxoplasmosis, a disease that may lead to neonatal and fetal complications. Infection by Toxoplasma occurs through ingesting raw or undercooked meat containing still viable cysts. Accurate diagnosis and timely intervention during pregnancy are crucial for mitigating adverse effects. This review aims to summarize current clinical approaches for the diagnosis and management of congenital toxoplasmosis. Different diagnostic methods such as polymerase chain reaction (PCR), immunosorbent agglutination assay (ISAGA), Western blot, and enzyme-linked immunosorbent assay (ELISA) show varying degrees of specificity and sensitivity. Additionally, combined methods improve diagnostic accuracy. Prenatal treatment spiramycin or pyrimethamine-sulfonamide regimens show effectiveness in reducing vertical transmission and disease severity, particularly when started early. Management of congenital toxoplasmosis postnatally needs regular monitoring and prolonged therapy due to high risk of side effects. Recently, multiple tools have emerged like recombinant antigens, microRNAs, and vaccine candidates and seemed promise but require further validation. Congenital toxoplasmosis remains a diagnostic and therapeutic challenge. While current strategies improve outcomes, global implementation of standardized screening and the development of safer, more effective interventions are needed to further reduce disease burden.