Diagnosis and treatment of congenital toxoplasmosis: an updated overview

Toxoplasmosis is a widespread protozoan infection that exhibits increased pathogenicity in its congenital form. The diagnosis and management of this condition require high accuracy and rapid intervention throughout the maternal-fetal and neonatal periods.

The aim of this review is to provide an updated overview of screening and diagnostic confirmation strategies for congenital toxoplasmosis, covering prenatal screening, neonatal assessment and long-term follow-up. It also examines therapeutic options for prenatal treatment based on gestational age.

Diagnostic strategies for congenital toxoplasmosis remain highly heterogeneous worldwide, ranging from intensive prenatal screening to a complete absence of systematic testing. When implemented, screening programs promote early diagnosis and treatment, with a positive impact on transmission and disease severity. The recent withdrawal of various key serological tests has forced laboratories to adopt and validate alternative diagnostic algorithms in complex situations. Pyrimethamine-sulfonamide is the cornerstone of treatment, but its toxicity profile remains a major limitation of current management. Cotrimoxazole appears to be a better-tolerated alternative that warrants consideration, although studies are still scarce.