Severe congenital toxoplasmosis: a case report and strain characterization

Abstract

We report a fatal congenital toxoplasmosis case in an Iranian woman in the south of Iran. A pregnant mother had been admitted at the 15th week of her pregnancy on account of a febrile illness, symptoms of common cold, and enlargement of submandibular lymph nodes. Serological testing of the mother's serum revealed positive IgG and IgM anti-Toxoplasma antibodies. Amniotic fluid was taken and evaluated by polymerase chain reaction (PCR) assay with a direct amplification of the Toxoplasma URPT gene which was found to be positive. Sequencing and analysis of PCR product revealed that the isolate has the most similarity with type I of Toxoplasma gondii. Fetal scan showed anomaly in fetus including mild hydrocephaly. Termination of the pregnancy was suggested by the physician and pregnancy was terminated 178 days after conception.

Figure 1

PCR product of Toxoplasma gondii amplified by UPRT primer. Lane 1: positive control (strain Rh of Toxoplasma gondii (type I)), lane 2: patient's amniotic sample, and lane 3: molecular marker.

Figure 2

Alignment of sequence of Toxoplasma isolated from amniotic fluid of the patient. Toxo SAK: sample from the patient; AY143152.1: sequence ID of Toxoplasma gondii strain type I uracil phosphoribosyltransferase (UPRT) gene.